Preparing Older Adults for Major Surgery With Preoperative Comprehensive Geriatric Assessments

NCT06184919 | Active Not Recruiting

• 5 other identifiers: 2022-1516A539707SMPH/SURGERY/COLON RECT1K23AG081487-012024-0044 [Aim 2]
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The researchers will conduct observations, interviews, and focus groups with clinicians, staff and patients of the Perioperative Optimization of Senior Health (POSH) clinic, which conducts preoperative comprehensive geriatric assessments (pCGA) at UW Health to understand clinic processes and potential areas for improvement. The goal is to (1) create a process map describing clinic workflow and (2) redesign the process with healthcare providers and patients/families.

Conditions

Surgery; Aging; Health Care Utilization; Frailty

Keywords

Human Factors Engineering; Perioperative Optimization

Outcome Measures

Primary Outcomes (2)

• Process map

  The direct observations, interviews and focus groups conducted with patients and caregivers will help create a detailed process map of preoperative geriatric assessments. Specifically this map will detail the persons, tasks, tools/technologies, environment and organizational factors involved in the process according to the System Engineering Initiative for Patient Safety model.

  12 months

• Implementation Package

  Co-design sessions will generate an implementation package, consisting of a set of implementation strategies, that can be piloted for its feasibility and adapted to facilitate preoperative comprehensive geriatric assessment in other settings.

  24 months

Secondary Outcomes (1)

• Qualitative data: Barriers and Facilitators to preoperative comprehensive geriatric assessments

  5 years

Study Arms (2)

Patients and caregivers

Patients attending the Perioperative Optimization of Senior Health (POSH) clinic

Other: Process Mapping: Observations; Other: Process Mapping: Interviews; Other: Participatory Design

Healthcare providers

Healthcare providers referring to or working in the Perioperative Optimization of Senior Health (POSH) clinic

Other: Process Mapping: Observations; Other: Process Mapping: Interviews; Other: Process Mapping: Focus Group; Other: Participatory Design

Interventions

Participatory Design OTHER

Participatory design, also called "co-design" is a systems engineering approach where the researchers and participants work together in designing the workflow of an intervention. There will be two groups (design teams) of patients/caregivers and healthcare professionals per location, for a total of four groups.

Healthcare providers; Patients and caregivers

Process Mapping: Observations OTHER

Direct observations of the POSH clinic visit.

Healthcare providers; Patients and caregivers

Process Mapping: Interviews OTHER

Semi-structured interviews of patients and providers involved in the POSH clinic.

Healthcare providers; Patients and caregivers

Process Mapping: Focus Group OTHER

Focus group of providers and staff who conduct the POSH clinic.

Healthcare providers

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Observations and Interviews in the Perioperative Optimization of Senior Health (POSH) clinic.

You may qualify if:

• Being a patient seen for a pCGA clinic at the time of observations, or being the caregiver of such a patient.
• Being a clinician or staff member working at the pCGA clinic
• Being a surgeon who frequently refers patients to the pCGA clinic

You may not qualify if:

• For patients:
• not being fluent in English
• having an enacted power of attorney indicating that the patient is unable to make medical decisions for themselves and a legally authorized representative (LAR) does not attend the pCGA visit with the patient
• For pCGA clinicians and staff: none
• For surgeons: none

Sponsors & Collaborators

• National Institute on Aging (NIA): collaborator
• University of Wisconsin, Madison: lead

Study Sites (1)

UW Hospital and Clinics

Madison, Wisconsin, 53792, United States

Location

Related Links

• Implementation Pilot of Preoperative CGA Before Major Surgery

MeSH Terms

Conditions

Patient Acceptance of Health Care; Frailty

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Julia R Berian, MD

  University of Wisconsin, Madison

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 13, 2023
• First Posted: December 29, 2023
• Study Start: June 14, 2023
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): April 30, 2028
• Last Updated: February 12, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)