VA launches new surgery initiative across the nation

WASHINGTON — This week, the Joint Commission and National Quality Forum announced VA’s Surgical Pause practice has been recognized with the prestigious John M. Eisenberg Patient Safety and Quality Award in the National Level Innovation in Patient Safety and Quality category for its innovative efforts resulting in improved health care outcomes of frail Veterans considering surgery.
The Surgical Pause is an initiative that uses a risk analysis index to screen Veterans for frailty in 30 seconds, effectively flagging high-risk Veterans so the surgical team can ensure the proposed treatment plans both mitigate known risks and align with the Veterans’ overarching life goals. Routine frailty screening with the RAI rapidly identifies the 5-10% of patients who experience disproportionately high rates of postoperative complication, loss of independence and mortality. For these patients, a brief “pause” permits further evaluation to review of goals of care and optimize treatment plans.
This initiative, which has already been launched at 50 VA facilities and is rolling out across the nation, is proven to decrease mortality among Veterans.A 2023 study published in JAMA Surgery reported that from July 1, 2016 to May 31, 2019, one-year mortality fell from 20% to 16% after implementing the Surgical Pause in a sample of more than 50,000 patients.
“The Surgical Pause is an innovative, data-driven clinical practice that saves Veterans lives by predicting and preventing complications before they happen,” said VA Under Secretary for Health, Shereef Elnahal, M.D. “We are thrilled to be rolling out the Surgical Pause across the nation as a part of VA’s steadfast commitment to providing Veterans with high-quality, world-class health care they deserve.”

VA is proven to be the best, most affordable health care in America for Veterans. In 2023 alone, peer-reviewed studies showed that VA health care is better than or equal to non-VA health care; nearly 70% of VA hospitals received 4 or 5 stars in the annual CMS Hospital ratings, compared to just 41% of non-VA hospitals; VA hospitals outperformed non-VA hospitals in all 10 patient satisfaction metrics in Medicare’s latest survey of patients; and more than 91% of Veterans trust VA with their care.
Surgical Pause is led by VA Pittsburgh Healthcare System Surgeon Daniel Hall, M.D., with support from VHA’s National Surgery Office, Office of Geriatrics and Extended Care and VHA’s Diffusion of Excellence program.
VHA’s National Surgery Office serves as a champion for the Surgical Pause, formally adopting it as a national initiative in 2023. The National Surgery Office will support implementation at VA facilities with surgical programs to further improve outcomes and align treatment plans with Veterans’ overarching life goals. To learn more, visit the Surgical Pause page.