The number of senior citizens in this country is rapidly rising, with those 65-and-older expected to nearly double by 2050. Today seniors undergo 38% of all surgeries in California — more than twice their current share of the population — and are at increased risk of adverse surgical outcomes such as complications, readmissions, and mortality. For these reasons, optimizing the surgical care of seniors has been a major focus of the American College of Surgeons (ACS) in recent years.
Dr. Banerjee, a surgeon with a passion for quality and patient safety, recognized an opportunity at his own medical center to improve outcomes among older patients undergoing hip fracture surgery. He began working in 2015 with physician colleagues to facilitate goals-of-care conversations with geriatric patients, institute facility-wide use of the ACS surgical risk calculator, and optimize pre- and post-surgical care. These efforts resulted in decreased orthopedic mortality at KP Fresno, findings that Dr. Banerjee presented at the national ACS Quality Conference in 2017.
The ACS contacted Dr. Banerjee to gauge interest in a national pilot program to develop surgical care standards for geriatric patients. With full leadership support, KP Fresno opted to participate as one of eight ACS pilot sites nationwide in 2018.
Dr. Banerjee focused KP Fresno’s Senior Surgical program on four pillars of geriatric surgical excellence: goals and decision-making; avoiding delirium; preventing functional deterioration; and nutrition and hydration. He garnered support from geriatricians, surgeons, hospitalists, emergency physicians, and palliative care physicians, and created teams to address every aspect of care. He also formed a multidisciplinary Senior Surgical Board for the highest-risk patients.
The ACS was impressed by our integrated pilot, calling it “head and shoulders above the pack.” Dr. Banerjee then led the modification of the program to implement it throughout KP Northern California in 2020. Data from mid-2021 revealed improvement in serious adverse outcomes regionwide.
“Dr. Banerjee’s energy, collaborative spirit, and belief in surgical excellence has shone through in the success of this valuable program,” says TPMG Associate Executive Director Smita Rouillard, MD. “He has advanced senior surgical care on a local, regional, and national scale.