{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T22:03:19Z","timestamp":1789855399189,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Older adults undergoing surgery are at increased risk for complications, functional decline, and prolonged recovery due to frailty and other age\u2010related vulnerabilities. To address these challenges, we developed the Care Coordination and Optimization in Geriatric Surgery (COGS) program, a pilot initiative integrating comprehensive geriatric assessment and targeted optimization into routine surgical care for Veterans. Using the Risk Analysis Index\u2010Clinical (RAI\u2010C) to identify higher\u2010risk patients, the COGS team\u2014comprising geriatric providers, nursing, and surgical staff\u2014provides individualized evaluation and interventions focused on nutrition, mobility, medication safety, cognition, and social support. By embedding geriatric expertise directly into the surgical clinic, the program fosters collaboration among surgeons and geriatricians, improving communication and supporting shared decision\u2010making about surgical readiness. Early experience demonstrates that COGS is both feasible and well\u2010received, enhancing the coordination of care for older Veterans and aligning surgical decisions with patients' goals and overall health status. Expansion of the program to additional surgical specialties and evaluation of short and long\u2010term outcomes are underway. The COGS model demonstrates how integrating geriatrics principles within surgical care can promote safer, more goal\u2010aligned surgery for older adults.<\/jats:p>","DOI":"10.1111\/jgs.70474","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T07:45:21Z","timestamp":1779522321000},"page":"2738-2745","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Care Coordination and Optimization in Geriatric Surgery (\n                    <scp>COGS<\/scp>\n                    ): A Pilot Program to Improve Surgical Outcomes in Older Adults"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0768-9244","authenticated-orcid":false,"given":"Gabrielle A.","family":"Scannell","sequence":"first","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole A.","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"},{"name":"Geriatrics Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs George E. Wahlen VAMC  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Rupper","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"},{"name":"Geriatrics Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs George E. Wahlen VAMC  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Veterans Affairs George E. Wahlen VAMC  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel J.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Northwest Permanente Medical Group  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"White","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Sauer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"},{"name":"Department of Veterans Affairs Salt Lake City Health Care System, IDEAS Center  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared Lareno","family":"Hansen","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"},{"name":"Department of Veterans Affairs Salt Lake City Health Care System, IDEAS Center  Salt Lake City Utah USA"},{"name":"Department of Veterans Affairs Elizabeth Dole Center of Excellence for Veteran and Caregiver Research  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Paul","family":"Eleazer","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of Utah Spencer Fox, Eccles School of Medicine  Salt Lake City Utah USA"},{"name":"Geriatrics Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs George E. Wahlen VAMC  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.024"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.5155"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13184"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)62167\u20109"},{"issue":"2","key":"e_1_2_12_7_1","first-page":"e94","article-title":"The Role of Frailty Assessment in Surgical Decision\u2010Making","volume":"1","author":"Hsieh L.","year":"2020","journal-title":"Lancet Healthy Longevity"},{"issue":"6","key":"e_1_2_12_8_1","article-title":"The Role of Frailty in Surgical Risk Assessment: A Prospective Cohort Study","volume":"3","author":"McDermott M. 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