At the University of Pittsburgh Medical Center (UPMC) in Pennsylvania, a team of clinicians and quality improvement specialists adopted the Risk Analysis Index (RAI), a risk score developed by Veterans Affairs (VA) to determine pre-operative frailty. The organization made the RAI a standard part of all pre-op visits for non-emergency surgery. UPMC saw a significant decrease in one-year mortality rates for post-op non-emergent patients, falling 0.2%-0.87% month over month after implementing the RAI, meaning that patients were three times more likely to be alive one year after their surgery. A similar program at the VA hospital in Omaha, Nebraska cut six-month mortality among the frail from nearly 25% to less than 8%, corresponding to a nearly three-fold survival advantage after controlling for age, frailty and comorbidities.
How They Did It:
- Screened patients for frailty prior to surgery
- Used risk scores in pre-op decision-making with patients
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