[AVBC 2025] Geriatric Perioperative Service Improves Healthcare outcomes
Care Process & Redesign
Appropriate & Value-based Care Conference
SingHealth
6 November 2025
The aim is to determine if a geriatric perioperative service (GPS) targeting the geriatric syndrome of cognitive impairment. The Geriatric Perioperative Service was effective in improving healthcare outcomes and demonstrated improved care processes that led.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Process ＆ Redesign, Productivity, Cost Saving, Access To Care, Readmission Rate, Quality Improvement, Clinical Practice Improvement, Adverse Outcome Reduction, Risk Management, Value Based Care, Safe Care
About this Content
Aims
The aim is to determine if a geriatric perioperative service (GPS) targeting the geriatric syndrome of cognitive impairment in the older perioperative population will improve 30-day non-elective readmissions, 90-day postoperative mortality, and other healthcare outcomes.
Background
Perioperative geriatric medicine is a sub-specialty that manages older adults before, during, and after surgery. Cognitively impaired older persons are at increased risk of delirium and adverse healthcare outcomes, yet cognitive impairment is often unrecognized and not routinely assessed preoperatively in older surgical patients.
Methods
A pragmatic before-after study of 50 patients from April 2023 until December 2024 was conducted, using 75 historical controls obtained from the period just preceding the intervention from July 2022 to March 2023. Participants and controls needed to fulfill criteria such as being aged 65 years and above, undergoing major surgery, and having diagnoses of delirium, mild cognitive impairment, or dementia.
Results
The GPS led to reductions in 30-day readmission, 90-day postoperative mortality, acute coronary syndrome, arrhythmia, and urinary tract infections. Length of stay improved by 4.5 days. GPS is associated with markers of improved perioperative care such as earlier feeding, urinary catheter removals, decreased dehydration episodes, and reduction in Anticholinergic burden.
Conclusion
The Geriatric Perioperative Service was effective in improving healthcare outcomes and demonstrated improved care processes that led to these outcomes.
Lessons Learnt
The study demonstrated that targeting cognitive impairment in the perioperative setting can lead to improved healthcare outcomes and processes.
Keywords
Geriatric, Perioperative, Delirium, Cognitive Impairment, Healthcare Outcomes
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Sengkang General Hospital, Duke-NUS, Geriatric Education & Research Institute |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Geriatric Medicine, Surgery |
Project Lead(s) | Tan Boon Hian |
Project Member(s) | Roshan Mahesh Lalmalani |
Connect with this contributor!
Tan Boon Hian - tan.boon.hian@singhealth.com.sg
Project Attachment
1063_SKGH_AVBC_2025_Geriatric_Perioperative_Service_Improves_Healthcare_outcomes.pdf