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Surgery center From page 1 monitored so that they can benefit from surgery to improve the length and quality of their lives. As part of the center’s clinical program, Katlic and his staff provide a tailored, individualized treatment plan for each patient. This starts with a comprehensive screening and assessment, which will determine a course of action based on the particular patient’s needs. “There is growing recognition in the medical community that [the traditional]
preoperative heart and lung testing in elderly surgical patients may not be sufficient, and that other ‘softer’ tests may be valuable in determining surgical risk,” said Katlic. The center’s clinical coordinators and full-time nurse practitioner perform an evaluation that includes a routine physical examination and laboratory studies, plus additional testing to evaluate frailty, activities of daily living, delirium risk, cognition, nutritional status, fall risk and current medications. They also do a specialized evaluation for the primary caregiver to see if he or she is
JANUARY 2014 — BALTIMORE BEACON
up to the challenge of caring for their recuperating loved one. According to Katlic, the results of this extensive evaluation are studied to determine what factors are most important in evaluating the risk of surgery to each patient. “The guiding principle of the Center for Geriatric Surgery is ‘just-right care’ — not too little, not too much, not too limited and not too aggressive,” said Katlic. Each patient works with a dedicated clinical coordinator to serve as his or her advocate during the inpatient postoperative stay, helping with daily medication review, family communication and discharge planning.
Hundreds of patients seen Approximately 400 patients have been evaluated since the center opened a little more than a year ago. The oldest patient the center has seen so far was 104 years old, and she suffered from breathing problems. If a patient’s pre-op evaluation raises red flags, his or her surgeon will be notified. That doesn’t necessarily mean the surgery won’t be performed, Katlic observed, but it gives the surgeon and the pre-op and post-op teams additional information that can help with decision-making and plan of care. “Our end goal is to optimize treatment,” said Katlic. Furthermore, he added, treat-
ment isn’t always about prolonging life, but often about offering a better quality of life. In addition to providing comprehensive clinical care for the elderly surgical patient, the center has an academic arm as well. Katlic noted that there is tremendous interest in the topic of geriatric surgery, not just in this country but also worldwide. So he plans to share the knowledge gained at the center with other medical professionals through clinical studies, articles, lectures and symposia, and a fellowship program. Word about the center is starting to get out: It has received coverage not only in the local media but in the New York Times as well. Katlic was recently named a 2013 Innovator of the Year by the Daily Record for his pioneering work in caring for older adults. Because of Katlic’s initiatives, hospitals around the country are developing centers similar to Sinai’s. And, as with Gloria Levin, other hospitals are beginning to send their older surgical patients to Sinai. “We’re geriatric-friendly,” said Katlic with a smile. As for Levin, the result of her experience at the Sinai Center for Geriatric Surgery speaks for itself. “I’m alive,” she said. “What else can I ask for?!” For more information about the Sinai Center for Geriatric Surgery, call (410) 601-WELL (9355) or visit www.lifebridgehealth/geriatricsurgery.
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