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Daniel E. Hall, MD, MDiv, MHSc
Hearty congratulations to Daniel E. Hall, MD, MDiv, MHSc, a VA surgeon and investigator with HSR’s Center for Health Equity Research & Promotion (CHERP) and former HSR Career Development Awardee! The Joint Commission and National Quality Forum (NQF) have named the Surgical Pause initiative, developed by Dr. Hall and colleagues with funding support from HSR, winner of the 2023 John M. Eisenberg Patient Safety and Quality Award in the National Innovation in Patient Safety and Quality category.
Presented annually, the Eisenberg Awards recognize major individual, local, and national achievements that improve patient safety and healthcare quality. The awards program honors the late Dr. John M. Eisenberg, former administrator of the Agency for Healthcare Research and Quality.
The Surgical Pause, which was awarded Gold Status by VA’s Diffusion of Excellence in 2019, facilitates assessment of surgical frailty by screening Veterans before surgery using a 14-item Risk Analysis Index (RAI) and national computerized patient record system (CPRS) template developed by Dr. Hall and colleagues. The Surgical Pause screens for frailty in approximately 30 seconds, reliably identifying Veterans who are at high risk of post-operative complications, loss of independence, and mortality. The “pause” enables further evaluation and optimization of treatment plans.
Initial experience with the Surgical Pause at the Omaha VAMC reduced six-month mortality of Veterans determined to be surgically frail from 25% to 8%. The results have been replicated at multiple medical centers as the practice was implemented across VA. Further analysis of more than 50,000 VA patients found that one-year mortality declined from 20% to 16%, an absolute reduction of 4%. With support from VHA’s National Surgery Office, Geriatrics and Extended Care, and the Diffusion of Excellence, the Surgical Pause has been implemented at more than 50 VA medical centers and in a growing number of private sector institutions.
“I am deeply grateful to the dedication and support of a small army of colleagues who helped make this program a reality. The VA’s forward-looking infrastructure joining operational excellence, transformative research, and practical diffusion identified, supported, and disseminated this practice from initial concept to national implementation in less than 10 years. I am privileged to work in such a supportive environment, dedicated to optimizing the care of Veterans.”—Dr. Daniel E. Hall
The achievements of Dr. Hall and other awardees will be featured in a special issue of The Joint Commission Journal on Quality and Patient Safety later this year.
