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Restructuring Care for Older Adults Undergoing Surgery: Preliminary Data from the Co‐Management of Older Operative Patients En Route Across Treatment Environments (CO‐OPERATE) Model of Care
Author(s) -
Walke Lisa M.,
Rosenthal Ronnie A.,
Trentalange Mark,
Perkal Melissa F.,
Maiaroto Maria,
Jeffery Sean M.,
Marottoli Richard A.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13098
Subject(s) - medicine , geriatrics , veterans affairs , orthopedic surgery , pharmacist , neurosurgery , health care , surgery , family medicine , pharmacy , psychiatry , economics , economic growth
Surgery is common in older adults, so geriatric and surgical providers need to develop expertise in the care of older adults undergoing surgery. The Co‐management of Older Operative Patients En Route Across Treatment Environments ( CO ‐ OPERATE ) program is a clinical and educational collaboration between geriatrics and several surgical specialties at Veterans Affairs Health Care Connecticut. Individuals in CO ‐ OPERATE are co‐managed during the pre‐, peri‐, and postoperative periods. General surgery, urology, vascular surgery, orthopedics, cardiothoracic surgery and neurosurgery all participate in the program, with geriatrics expertise provided by a geriatrician, geriatric nurse practitioner and a geriatric clinical pharmacist. In the initial 3 years, there were 211 CO ‐ OPERATE participants; 31% were evaluated preoperatively, and 62% of the individuals seen preoperatively were seen in clinic. There was a median of three recommendations per consultation. At discharge, 56% returned to the community. Individuals seen preoperatively were more likely to return to the community (63%) than those seen after surgery (50%, P = .10). Geriatrics co‐management with a variety of surgical specialties is feasible and may be associated with higher rates of discharge back to the community.