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Invited Commentary
February 12, 2020

Care Redesign for Emergency General Surgery in Older Adults

Author Affiliations
  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina
  • 2Department of Medicine, Duke University Medical Center, Durham, North Carolina
  • 3Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, North Carolina
  • 4Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina
JAMA Surg. 2020;155(4):e196022. doi:10.1001/jamasurg.2019.6022

Emergency surgery is fundamentally directed toward preserving life, yet quality of life is most valuable to patients and clinicians. Khadaroo et al1 describe a quality improvement initiative where older adults undergoing emergency general surgery were physically colocated into a single unit, with the goal of reducing complications and death by providing patient-centered rehabilitation and early planning for discharge. They used the Elder-Friendly Approach to the Surgical Environment (EASE) model with consultation from a geriatrics specialist and an interdisciplinary team. This type of care redesign for older adults undergoing emergency surgery is commendable and impactful because even minor surgical procedures are associated with high risk in vulnerable elderly individuals.2

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