Unity recognized for its care of geriatric surgical patients

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Unity Hospital is the first in the nation to achieve a designation from the American College of Surgeons that recognizes its dedication to providing optimal care for its older adult patients.

The American College of Surgeons’ Geriatric Surgery Verification Program granted Unity Hospital Level 1 — Comprehensive Excellence verification status.

The American College of Surgeons introduced the GSV program in 2019.

Its mission is to improve the quality of geriatric surgical care by creating a system that allows for a prospective match of every older adult’s individual surgical needs with a care environment that has optimal resources for the patients undergoing inpatient surgery.

Unity Hospital achieved the Level 1 status by demonstrating that the GSV program standards are verified across one or more surgical specialties and reach 50 percent or more of the hospital’s total population of eligible surgical patients aged 75 years or older.

Matthew Schiralli, MD, Director of the Geriatric Program and Chair of Surgery for the Eastern Region for Rochester Regional Health, says the verification status demonstrates the hospital’s commitment to providing the highest level of patient care.

“We are creating a new standard of care,” Schiralli said.

Unity was one of a handful of beta sites across the country chosen to participate in the GSV program, and the first hospital to successfully complete the process and receive verification.

A multi-disciplinary team was assembled for the program, which included medical professionals from all areas, Schiralli said.

The diverse group ranged from surgeons, hospital physicians, advanced practice providers and anesthesiologists to physical therapists, nutritionists, pharmacists and geriatricians.

The group spent roughly three years on the verification process, beginning pre-COVID and continuing work during the pandemic, he said.

In addition to the time each group participant spent working on the program, there was also a large infrastructure build-out to support it, Schiralli noted.

While Unity is the first hospital within Rochester Regional Health to receive the designation, the goal is to make it a system-wide initiative tailored to the needs of each site, Schiralli said.

There are plans in place for the remaining four hospitals within the system to acquire the designation, as well, he said. They are Rochester General, United Memorial Medical Center in Batavia, Clifton Springs Hospital & Clinic and Newark-Wayne Community Hospital.

A hallmark of the new standard is an emphasis on individual patient needs, Schiralli said.

That means clinicians work with patients to find out what is important in their lives and what path should be taken to best help patients reach their goals.

The mindset is especially new to geriatric patients who traditionally follow doctor’s orders with little input of their own, Schiralli noted.

The focus is on empowering patients and their families.

“We want them to tell us what’s important to them,” he said.

Pasquale Iannoli, MD, Department of Surgery Chair at Unity Hospital, said that in Rochester, and across the country, there is a growing geriatric population who has medical needs that are different from other age groups.

The new program incorporates those needs and covers the entirety of a patient’s care, from pre-operative testing to post-operative care and beyond.

“A safety net is created around the patient by the entire team, giving that patient the best opportunity for a good outcome,” Iannoli said, adding that adding increasing safety decreases the chance of complications and leads to higher patient satisfaction.

For example, an 85-year-old woman who needs to have hip surgery may also be screened for factors such as dementia and ambulatory or swallowing challenges. If red flags arise in those areas, work may be done there first to ensure the woman is in optimal health to undergo the surgery, Iannoli explained.

The process is ideal for those undergoing elective surgeries who have time to address other issues compared with emergency operations that need to be performed immediately, he said.

The approach is different from what is currently seen in the medical arena, which means it brings with it the willingness of those in the field to change and adapt, Iannoli said.

Changing mindsets can be hard, but the team at Unity was willing to do the work, he said.

“It’s important to think beyond everyday routines and affect positive change,” he said, noting early adopters such as Unity can serve as an example for other hospitals across the country. “It’s about changing how we think about the problem.”

Although the program is in its early stages it is already showing positive results, Iannoli said.

Data has shown a drop in mortality rates and serious morbidities among the geriatric population treated, he said, adding there is more success to come.

“We are just getting started,” Iannoli said.

Andrea Deckert is a Rochester-area freelance writer.