As Medicare has focused more on hospital readmissions and care transitions over time, programs and movements aimed at providing geriatric-focused care have developed nationally. These programs aim to minimize and prevent hazards of hospitalization, decrease readmissions, provide safer transitions to the post-acute setting, and decrease length of stay while acknowledging and addressing specific care considerations of hospitalized older adults, such as dementia, sensory impairment, and mobility impairment. Inpatient geriatric assessments help providers tailor care plans to the specific needs of individual hospitalized older adults and determine their post-acute care needs, and also help with appropriate counseling of family and caregivers. Prevention measures are vital during hospitalization of older adults, who are at higher risk of delirium, pressure injury, falls, aspiration, malnutrition, sleep disturbances, and venous thromboembolism. Detailed transition plans and specialized discharge summaries are important to highlight the needs of older adults as they transition to post-acute care settings, and should allow for providers to resume the care plan seamlessly, including continuation of advanced care planning conversations.

Surgical patients undergo multiple transitions of care, from home to the operating room, to a recovery unit to a ward, and so on. Each transition poses a risk of medication error if the current medications are not reconciled or managed appropriately in the new phase of care. Home medications may be suspended, stopped, substituted for, or need to be continued, often in the face of changing preoperative guidelines. Admission and discharge medication reconciliations are at high risk for inaccuracies and for mis-information for the patient as well as the patient's primary provider. Intraoperative medication management is largely but not exclusively, under the control of the anesthesiologist, who serves as the sole agent for the prescription, dispensing, preparation, administration, documentation and monitoring of the anesthetic medications. Common errors include syringe or vial swaps, omissions (e.g., no redosing of antibiotics), wrong route, wrong dose, and even wrong choice of medication. Medication errors occur in approximately every 2 anesthetics, most are of little to no harm, but each has the potential for significant injury. Medication errors also can be made by a surgeon or OR nurse; communication failures between care team members often contribute.