{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T07:57:27Z","timestamp":1774252647798,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A growing number of emergency general surgery (EGS) admissions comprise of adults age 65\u00a0years and older, who are more likely to experience missed or delayed diagnoses, and subsequently worse postoperative outcomes. We aimed to ascertain the perspectives of clinicians on the diagnostic challenges unique to older adults with EGS conditions and strategies to improve feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this qualitative study, semi\u2010structured focus groups were conducted with frontline clinicians with experience in providing high volume care to older adult EGS patients to explore diagnostic challenges, tools, and feedback strategies. Questions focused on clinical gaps and approaches, tools, and the mechanisms in place to provide feedback on patient diagnosis and assessment. Focus groups were transcribed and qualitatively analyzed using an inductive approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010two clinicians participated in one of six focus groups. Clinicians reported three key diagnostic challenges: nontextbook presentations, comorbidities, and older\u2010age specific complications. Nondiagnostic factors remained high priorities including functional health status, patient preferences, family involvement, and health related social needs. Practical tools addressing these gaps included the use of multidisciplinary expertise, surgical risk calculators, cognitive assessments, functional health assessments, and protocols guiding goals of care discussions. Participants shared barriers and facilitators for implementation of these tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frontline clinicians identified several high priority considerations unique in EGS for older adults. To address these, context\u2010specific tools and strategies were detailed and inform ongoing work to incorporate feedback and solutions into frontline settings. Future work in quality improvement should incorporate these high priority areas into existing quality improvement frameworks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70237","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T03:24:58Z","timestamp":1770002698000},"page":"606-615","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Diagnostic Challenges and Performance Feedback in Older Adult Emergency General Surgery"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2706-746X","authenticated-orcid":false,"given":"Jessica K.","family":"Liu","sequence":"first","affiliation":[{"name":"Division of Research and Optimal Patient Care American College of Surgeons  Chicago Illinois USA"},{"name":"Department of Surgery Harbor UCLA Medical Center  Torrance California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9079-1614","authenticated-orcid":false,"given":"Xane D.","family":"Peters","sequence":"additional","affiliation":[{"name":"Division of Research and Optimal Patient Care American College of Surgeons  Chicago Illinois USA"},{"name":"Department of Surgery Loyola University Medical Center  Maywood Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7760-4251","authenticated-orcid":false,"given":"Sarah L.","family":"Remer","sequence":"additional","affiliation":[{"name":"Division of Research and Optimal Patient Care American College of Surgeons  Chicago Illinois USA"},{"name":"Department of Surgery Loyola University Medical Center  Maywood Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5922-4154","authenticated-orcid":false,"given":"Amanda J.","family":"Reich","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Department of Surgery Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifford Y.","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Research and Optimal Patient Care American College of Surgeons  Chicago Illinois USA"},{"name":"Department of Surgery David Geffen School of Medicine at University of California Los Angeles VA Greater Los Angeles Healthcare System  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000005077"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.03.001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.08.026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908501003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.005017"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010016\u20100329\u20108"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16046"},{"key":"e_1_2_11_9_1","volume-title":"2020 Census: 1 in 6 People in the United States Were 65 and over","year":"2023"},{"key":"e_1_2_11_10_1","unstructured":"Medicare and Medicaid Programs and the Children's Health Insurance Program Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long\u2010Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes Centers for Medicare & Medicaid Services (CMS) Department of Health and Human Services (HHS). 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