The UTSW POSH Program

Specialized care for older patients needing surgery

What is the POSH Program? The UT Southwestern Perioperative Optimization of Senior Health (UTSW POSH) Program is an innovative, interdisciplinary model of care designed for older adults undergoing elective surgical procedures.

Making the process smoother – and safer – before and after the procedure

Presurgery service

This program is specifically designed to evaluate older adults before surgery, to anticipate any risk of adverse postoperative events, and to provide an optimization plan to avoid complications and improve outcomes.

Postsurgery service

After the procedure, UTSW POSH care team members continue to provide consultative management of medical comorbidities, make recommendations for delirium prevention, and assist with a safe transition out of the hospital.

Comprehensive benefits

Patients in the UTSW POSH Program receive the following advantages:

  • Complete preoperative evaluation and risk assessment resulting in a plan for optimization
  • Coordination of care based on recommendations from the POSH multidisciplinary team
  • Improved patient outcomes

Who is eligible for the program?

  • Patients who are age 85 or older, or
  • Patients who are age 70 or younger who also:
    • Have a known or suspected cognitive impairment
    • Use more than five medications
    • Have three or more chronic conditions
    • Have experienced an unintended weight loss of more than 10 lbs. in one year

Our goal: ensuring the procedure is as seamless as possible

Following an initial geriatrics evaluation, the UTSW POSH team’s plan for optimization might include:

  • Referral to physical therapy prior to surgery
  • Referral to nutrition prior to surgery
  • Referral for further testing for risk stratification (e.g., stress test, echocardiography, etc.)
  • Recommendations for perioperative medication management
  • Recommendations for delirium prevention
  • Referral to social work to assist with obtaining needed support at home or to assist with developing a postoperative discharge plan

Meet the team

Thomas Dalton, M.D. (Geriatrics, Internal Med)

Megan Maxwell, M.D. (Anesthesiology & Pain Med)

Cynthia Wang, M.D. (Anesthesiology & Pain Med)

Sarah Wingfield, M.D. (Geriatrics, Internal Med)


To learn more, read our Frequently Asked Questions or call the UTSW POSH team at 214-645-8617.

This work has been made possible in part through a collaboration with the team that developed the original Perioperative Optimization of Senior Health (POSH) Program at Duke University. For more information, click here.