Nurse Practitioner–Led Initiative Improves Care in Frail Patients Undergoing Surgery

Abstract

Surgical Pause is a new national program in the Department of Veterans Affairs aimed at improving surgical outcomes. The Risk Analysis Index, a validated 14-item instrument that measures surgical frailty, is used to identify patients at high surgical risk at the point of care before surgery. This article describes the creation of a nurse practitioner–led quality improvement initiative to create an interdisciplinary high-risk quality surgery board and integrate it with the preoperative Risk Analysis Index to augment frailty screening, risk stratification, and management of high-risk older frail surgical patients in a tertiary Veterans Affairs medical facility.