The UTSW POSH Program

The UT Southwestern Perioperative Optimization of Senior Health (POSH) Program is a service offered by the Division of of Geriatric Medicine and the Departments of Surgery and Anesthesiology that is aimed at providing comprehensive evaluation of older adults who are planning to undergo surgery.

The program is led by a physician who is board certified in internal medicine and geriatric medicine. The physician will perform a comprehensive preoperative evaluation to anticipate your individual risks related to surgery, and then develop a plan to help optimize your health status throughout the surgical period to ensure the best possible outcome. The evaluation is focused on understanding the status of chronic health problems, ensuring appropriate prescribing, and analyzing the risks for complications that threaten the older adult facing surgery. In addition, a geriatric medicine consult team will help care for you while you are in the hospital following surgery, assisting the surgical team in managing chronic medical conditions, preventing complications, and aiding you as you transition safely from the hospital following discharge.

You will see a UT Southwestern geriatrician who will discuss your goals and expectations for your surgery. Your medical history and any current conditions for which you are being treated will be reviewed with you, along with your risk of developing complications after surgery. You will also have an evaluation of your mood and your risk of developing confusion after the surgery. Your ability to complete your daily activities will be assessed in order to allow planning for care following your surgery. Based on the findings of the assessment, you might need additional lab tests, heart function assessment tests, preoperative physical therapy, or changes to your medications.

You might have a Pre-surgery Testing (PST) appointment in addition to your UT Southwestern POSH appointment. This PST appointment could be necessary to allow a targeted evaluation by an anesthesia provider to develop the best plan for management of your anesthesia during surgery and management of any pain following surgery. If there are questions about insurance coverage or payment for your hospitalization, you might also receive financial counseling at this appointment. Based on the results of your visit with the geriatrician, you could need other specialized testing or evaluation by physical therapists or other medical specialists.

Please bring an accurate list of all medicines you take, including over-the-counter medications and supplements. It is also very important that a family member or loved one come with you.

Please remember that your surgeon is referring you to the UTSW POSH team because he or she wants to ensure that you have the best possible outcome before and after your operation.

The UTSW POSH Program is a collaborative effort among the physicians who will care for you around the time of surgery. We will communicate with each other regarding your care plan.

Prior to surgery:

• Place an order for a UTSW POSH consult in EPIC at the time the decision for surgery is made.
  
• The patient will be called by a geriatrics clinic staff member to schedule a preoperative appointment.
  
• Continue to also schedule the patient for the presurgical testing (PST) clinic for his or her anesthesia evaluation.
  

Postoperatively:

• Enter an order for a geriatrics consult.