Perioperative Care of the Older Adult

 At Mass General Brigham trauma centers, over 50% of injured patients are older adults, the majority of whom are frail. To prepare our health care system to care for the growing number of older adults who have increasing medical and psychosocial complexity and improved standards for geriatric surgical care being set by national stakeholders including CMS and the American College of Surgeons, front line clinicians including Advanced Practice Providers (APPs), surgical trainees, nurses, and surgical attendings urgently need more training in geriatric syndromes and the 4 pillars of Age-Friendly Health Systems (Medication, Mobility, what Matters, and Mentation) as well as multi-complexity. 

This training will address the needs of geriatric patients and instruct on how to avoid hazards of hospitalization such as delirium, falls, infections, loss of function, and caregiver strain. These issues are particularly relevant in surgery and trauma where mortality, complications, and other adverse outcomes are consistently higher for older patients than their younger counterparts. Evidence suggests that geriatric-focused clinical pathways can reduce delirium, ICU stays, length of stay, and readmissions in older surgical patients. Clinicians will benefit from in-depth training in geriatric care to enable the implementation of structures and processes to improve outcomes.