Geriatrics-surgery co-management program [Neurosurgery Wiki]

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====== Geriatrics-surgery co-management program ======

[[Geriatric]]s-surgery co-management [[program]]s are healthcare [[initiative]]s designed to improve the [[care]] and [[outcome]]s of [[older adult]] patients ([[geriatric patient]]s) who require surgery. These programs recognize the unique needs and challenges of older surgical patients and aim to provide comprehensive care that takes into account their medical, functional, and social complexities. The collaboration between geriatric medicine specialists and surgical teams is a key component of such programs. Here are some key aspects of geriatrics-surgery co-management programs:

Comprehensive Assessment: Geriatric patients often have multiple chronic medical conditions and age-related changes that can impact their surgical outcomes. In these programs, patients undergo a comprehensive pre-operative assessment that considers their medical history, medications, cognitive function, mobility, and social support.

Multidisciplinary Team: These programs involve a multidisciplinary team of healthcare professionals, which may include geriatricians (physicians specializing in geriatric medicine), surgeons, anesthesiologists, nurses, physical and occupational therapists, pharmacists, and social workers. This team collaboratively develops a care plan tailored to the individual patient's needs.

Individualized Care Plans: Each patient's care plan is personalized to address their specific health and functional issues. For example, medication adjustments may be made, and strategies for managing cognitive impairment or delirium risk may be implemented.

Optimization of Health: Pre-operative optimization may include managing chronic medical conditions, nutrition assessment, exercise programs, and other interventions aimed at improving the patient's overall health and functional status before surgery.

Minimizing Postoperative Complications: Efforts are made to reduce the risk of postoperative complications, such as delirium, infections, falls, and adverse drug events. This may involve specialized monitoring and interventions during the perioperative period.

Postoperative Rehabilitation and Recovery: Geriatrics-surgery co-management programs often emphasize rehabilitation and functional recovery. Physical and occupational therapy may be an integral part of the postoperative care plan to help patients regain their independence and mobility.

Shared Decision-Making: The program encourages shared decision-making, involving patients and their families in the decision-making process regarding surgical interventions, taking into account the potential benefits and risks.

Communication and Continuity of Care: Improved communication among healthcare providers, including timely follow-up appointments and coordination of care, is a central aspect of these programs to ensure a smooth transition from surgery to recovery.

Research and Evaluation: Ongoing research and evaluation of the program's outcomes are essential to assess its effectiveness and make necessary improvements.

These co-management programs aim to provide older surgical patients with the best possible surgical experience while minimizing complications and improving their overall quality of life. By addressing the unique needs of geriatric patients, these programs seek to ensure that they receive safe and effective surgical care.
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Clinicians across diverse surgical specialties valued GSCM. Hospitals considering implementation or expansion of GSCM should attend to identified facilitators and may need to tailor to specialty
((Gupta S, Walke L, Simone M, Michener A, Nembhard I. The perceived value of a geriatrics-surgery co-management program: Perspectives from three surgical specialties. J Am Geriatr Soc. 2023 Nov 10. doi: 10.1111/jgs.18636. Epub ahead of print. PMID: 37947016.))