The following is a summary of “Shared Decision Making in the Geriatric Surgery Verification Program: Assessing Baseline Performance,” published in the JUNE 2023 issue of Pain Management by Streid, et al.
In 2019, the American College of Surgeons introduced the Geriatric Surgery Verification program, which included care standards for older patients, including requirements for documenting preoperative goals. However, the baseline performance of hospitals on these standards before the program’s implementation is still being determined. Therefore, for a study, researchers sought to assess the baseline performance of the Geriatric Surgery Verification (GSV) standard for documenting preoperative goals in older patients and identify factors associated with adherence to the standard.
The study utilized natural language processing to analyze electronic health records of patients aged 65 or older who underwent coronary artery bypass grafts (CABG) or colectomies at three hospitals in 2017 or 2018. The primary outcome was adherence to at least one of the three components of GSV Standard 5.1, which requires preoperative documentation of overall health goals, treatment goals, and patient-centered outcomes.
A total of 2,630 operations and 2,563 patients were included in the analysis. The standard was met for at least one component in 307 (11.7%) operations, while all three were met in only 5 (0.2%) cases. Factors associated with a higher likelihood of meeting the standard included being female (odds ratio [OR] 1.30; 95% CI 1.00–1.68), undergoing colectomy (OR 2.82; 95% CI 2.15–3.72), and having more comorbidities (Charlson scores >3 [OR 1.55; 95% CI 1.14–2.09]).
Before implementing the GSV program, clinicians rarely met the standard for preoperative discussion of patient goals in the context of coronary artery bypass grafts and colectomies. Interdisciplinary teams will need to make adjustments to their clinical practices to meet the best-practice communication standards for older patients outlined by the program.