An expert panel using the RAND/UCLA Appropriateness Methodology rated 91 of 96 candidate process-based quality indicators as valid for improving perioperative care in elderly surgical patients.
A modified RAND/UCLA Appropriateness Methodology identified 91 valid process-based quality indicators to improve perioperative care for elderly surgical patients.
In Brief Objective: To develop process-based quality indicators to improve perioperative care for elderly surgical patients. Background: The population is aging and expanding, and physicians must continue to optimize elderly surgical care to meet the anticipated increase in surgical services. We sought to develop process-based quality indicators applicable to virtually all disciplines of surgery to identify necessary and meaningful ways to improve surgical care and outcomes in the elderly. Methods: We identified candidate perioperative quality indicators for elderly patients undergoing ambulatory, or major elective or nonelective inpatient surgery through structured interviews with thought leaders and systematic reviews of the literature. An expert panel of physicians in surgery, geriatrics, anesthesia, critical care, internal, and rehabilitation medicine formally rated the indicators using a modification of the RAND/UCLA Appropriateness Methodology. Results: Ninety-one of 96 candidate indicators were rated as valid. They were categorized into 8 domains: comorbidity assessment, elderly issues, medication use, patient-provider discussions, intraoperative care, postoperative management, discharge planning, and ambulatory surgery. Of note, 71 (78%) of the indicators rated as valid address processes of care not routinely performed in younger surgical populations. Conclusions: Attention to the quality of care in elderly patients is of great importance due to the increasing numbers of elderly undergoing surgery. This project used a validated methodology to identify and rate process measures to achieve high quality perioperative care for elderly surgical patients. We identified candidate perioperative quality indicators for elderly patients undergoing surgery through structured interviews with thought leaders and systematic reviews of the published data. A total of 91 indicators categorized into 8 domains were rated as valid. This project used a validated methodology to identify and rate process measures to achieve high quality perioperative care for elderly surgical patients.
McGory et al. (2009) studied Elderly surgical patients. Process-based quality indicators was evaluated on Validity of candidate perioperative quality indicators. An expert panel using the RAND/UCLA Appropriateness Methodology rated 91 of 96 candidate process-based quality indicators as valid for improving perioperative care in elderly surgical patients.