The Duke Center for Geriatric Surgery (DCGS) is envisioned to be the collaborative platform to develop and integrate advances in perioperative care for older adults through clinical innovation, education, and research. The DCGS builds on the success of current programs, namely, Perioperative Optimization of Senior Health Clinic (POSH), Nurses Improving Care for Health system Elders (NICHE), Health Optimization Program for Elders (HOPE), and Educational Leadership Immersion Training in ELDERcare (ELITE).
Background
Over a third of inpatient surgical procedures in the U.S. are performed on adults over age 65, a population segment that suffers the highest rates of complications, leading to longer hospitalizations and loss of independence. Multidisciplinary, interprofessional care at Duke University is based on a person-centered approach that engages patients and families in the perioperative planning process by encouraging attendance at the preoperative visit. Family participation facilitates establishing realistic goals, shared decision making, and advanced care planning. Comprehensive coordinated care for complex older adults relies on active participation and unique perspectives and skillsets of health professionals from multiple disciplines including nursing, social work, geriatric medicine, surgery, and anesthesia with communication back to the patient’s community health care providers. Incorporating geriatric principles and expertise for older adults preparing for elective surgeries can help reduce the likelihood of complications and may improve outcomes for this growing high-risk demographic.