Use of a Pre-surgical Toolkit in Improving Surgical Care and Outcomes in Older Patients with Cancer

Summary

Objectives

PRIMARY OBJECTIVE:
I. To compare 8-week postoperative function among elderly patients between sites randomized to implement the OPTI-Surg toolkit with or without a coach versus sites randomized to usual care.

SECONDARY OBJECTIVES:
I. To compare postoperative morbidity between sites randomized to implement the OPTI-Surg toolkit with or without a coach versus sites randomized to usual care.
II. To compare the penetration of the OPTI-Surg toolkit between sites randomized to implement the OPTI-Surg toolkit with a coach versus sites randomized to implement the OPTI-Surg toolkit without a coach.

EXPLORATORY OBJECTIVES:
I. To compare postoperative mortality, hospital length of stay, discharge to a facility, and hospital readmission between sites randomized to implement the OPTI-Surg toolkit with or without a coach versus sites randomized to usual care.
II. To assess subsequent initiation and follow through of appropriate referral for the indicated optimization intervention and assess practice-level structural factors associated with uptake of the OPTI-Surg package.
III. To document and assess barriers and facilitators to implementation and dissemination through mixed-methods research.

OUTLINE: Healthcare providers/institutions are randomized to 1 of 3 arms. Patients receive the intervention based on which arm their healthcare provider is in.

ARM I: Healthcare providers/institutions perform usual care.

ARM II: Healthcare providers/institutions receive OPTI-Surg training and informational materials.

ARM III: Healthcare providers/institutions receive OPTI-Surg training and informational materials and meet with a coach.

After conclusion of study, patients are followed up at 8 and 12 weeks post surgery, and healthcare providers/institutions are followed up 6-9 months after the last patient is registered.