Trauma Surgery & Acute Care Open (Dec 2021)

Making your geriatric and palliative programs a strength: TQIP guideline implementation and the VRC perspective

  • Deborah M Stein,
  • Vanessa P Ho,
  • Saman Arbabi,
  • Kathleen M O'Connell,
  • Sasha D Adams,
  • Christine S Cocanour,
  • Elisabeth B Powelson

DOI
https://doi.org/10.1136/tsaco-2021-000677
Journal volume & issue
Vol. 6, no. 1

Abstract

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Background Older patients compose approximately 30% of trauma patients treated in the USA but make up nearly 50% of deaths from trauma. To help standardize and elevate care of these patients, the American College of Surgeons (ACS) Trauma Quality Improvement Program’s best practice guidelines for geriatric trauma management was published in 2013 and that for palliative care was published in 2017. Here, we discuss how palliative care and geriatrics quality metrics can be tracked and used for performance improvement and leveraged as a strength for trauma verification.Methods We discuss the viewpoint of the ACS Verification, Review, and Consultation and three case studies, with practical tips and takeaways, of how these measures have been implemented at different institutions.Results We describe the use of (1) targeted educational initiatives, (2) development of a consultation tool based on institutional resources, and (3) application of a nurse-led frailty screen.Discussion Specialized care and attention to these vulnerable populations is recommended, but the implementation of these programs can take many shapes.Level of evidence V