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A new initiative led by WMU Homer Stryker M.D. School of Medicine (91̽��) aims to improve health outcomes for elderly surgical patients through a combination of elder-specific medical care and community resources. 

The Surgical Transitions in Aging Residents (STAR) program, designed for elder patients undergoing major elective or emergency operations, provides multiple interventions including geriatrics consultation and connection to community resources related to food, housing, and transportation, among others, to support a faster and more complete recovery. 

The program, launched in April 2025 within the General Surgery practice at 91̽�� Health, is being supported by a nearly $500,000 grant from the Michigan Health Endowment Fund. The funding will be used to strengthen collaborations with community partners, hire additional personnel to help screen patients for the program, and collect data on patient outcomes, according to 91̽�� Dean Robert G. Sawyer, MD. 

“In medicine, kind of where we are right now is we have a lot of resources that are poorly coordinated,” Dr. Sawyer said. “We have the expertise, we have the surgeons, and for better or for worse, we tend to work relatively independently. With this project, I am excited about the fact that we can bring together all of these different areas of knowledge to support better outcomes.” 

Pre- and post-operative patients 65 and older are screened by STAR Coordinator Jill Chambers, PA-C, to identify medical high-risk characteristics that predict an elevated chance of complications, including:  

• Polypharmacy (taking five or more medications)  
• Multiple significant comorbidities (three or more treated illnesses)  
• Residence in a nursing home or other facility  
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• Expected length of hospital stay greater than two midnights  
• Intra-abdominal procedure, intra-thoracic procedure, or limb amputation  
• General anesthesia  
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Patients with these risk factors are referred to Daniel Brauner, MD, division chief of Division of Geriatrics at 91̽��, for pre- and post-operative evaluation, including a thorough examination of underlying diseases, medications, and a discussion of potential benefits, risks and burdens. 

“The standards of care for older people need to be individualized,” Dr Brauner said. “I have a long conversation with the patient. I get to hear their lived experience of those illnesses and drugs and talk about the narrative of what’s happened to them over the years. ... I think a lot of patients have never really done that, and they don’t see the bigger picture because they're dealing with their problems in the moment. For many of them, it’s very revelatory and I think they really appreciate that opportunity.” 

Similarly, patients 65 and older that undergo unscheduled emergency operations are screened post-operatively by Chambers for potential follow-up with Dr. Brauner. 

So far, nearly 100 patients have been referred to the program, according to Chambers. 

“It’s a nice full-circle picture,” Chambers said. “Most patients are excited about it. Some say they already have a primary care provider, but this is to compliment that, not to take away from that. ... We try to let people know that we have a lot of resources we can offer.” 

A key component of the program involves strengthening collaborations with local partners, including the Area Agency on Aging (AAA) and Program of All-Inclusive Care for the Elderly (PACE) in Kalamazoo County, connecting patients with additional wraparound services through these community programs including food, transportation, and housing. 

“These wonderful programs exist in the community to support our aging population, completely separate from anything to do with medicine,” Dr. Sawyer said. “They have a lot of resources to offer, and we should be able to avail ourselves in our specific patient population of all of these services.” 

By mid-2026, the hope is to expand the STAR program to include surgical patients at Kalamazoo’s two hospitals, Beacon Kalamazoo Hospital and Bronson Methodist Hospital, and ultimately, to provide a successful template for managing elderly surgical patients that can be easily replicated throughout the state. 

“Delving into and exploring what’s happening with patients and trying to figure out how we can make their lives better in some way, that to me is very fulfilling,” Dr. Brauner said. “Being able to have that time to really explore what’s going on and what we can do to really help the patients, that’s what excites me about this program.”