The goal is to reduce inpatient length-of-stay in post-surgical patients by implementing Pre-op choice of Home Health Agency or SNF. This is currently initiated post-op. Patients more likely to need post-acute care (identified via e-FI preoperatively) will also improve other decisions related to pre-habilitation, post-op care, and whether or not surgery is the best option. Desired outcomes include: reduced length of stay, improved patient and provider satisfaction, and improved use of time in the SNC™.


The Aging and Alzheimer’s and Surgical Navigation Center Clinical-Academic Interface will: 

  • Increase access by reducing bed-days for Medicare beneficiaries undergoing elective surgery; 
    • Promote safe, high quality, leading-edge care for older adults, optimizing cognitive and physical function: 
    • Function First in the Surgical Navigation Center (FF-SNC™) will prevent delirium and promote mobility in older adults undergoing surgery; 
  • This will reduce LOS (cost per-case) and improve surgical outcomes 
  • Increase research participation through studies in CHAAP 
  • Expand identification of at-risk older adults across WFBHS service lines and implement new Function First pathways: 
    • FF-SNC™ will serve as a paradigm for scaling to additional service lines


  • To refine risk prediction modeling for older adults at-risk for post-operative delirium  
  • To assess feasibility and acceptability of physical, cognitive, and biomarker testing for delirium

Did You Know?

  • Delirium is more common in older adults with cognitive impairment, AND Delirium is a modifiable risk factor for cognitive impairment and dementia