Contrary to the intraoperative period, the current perioperative environment is known to be fragmented and expensive. One of the potential solutions to this problem is the newly proposed perioperative surgical home (PSH) model of care. The PSH is a patient-centred micro healthcare system, which begins at the time the decision for surgery is made, is continuous through the perioperative period and concludes 30 days after discharge from the hospital. The model is based on multidisciplinary involvement: coordination of care, consistent application of best evidence/best practice protocols, full transparency with continuous monitoring and reporting of safety, quality, and cost data to optimize and decrease variation in care practices. To reduce said variation in care, the entire continuum of the perioperative process must evolve into a unique care environment handled by one perioperative team and coordinated by a leader. Anaesthesiologists are ideally positioned to lead this new model and thus significantly contribute to the highest standards in transitional medicine. The unique characteristics that place Anaesthesiologists in this framework include their systematic role in hospitals (as coordinators between patients/medical staff and institutions), the culture of safety and health care metrics innate to the specialty, and a significant role in the preoperative evaluation and counselling process, making them ideal leaders in perioperative medicine.

Iconographies supplémentaires de l'article : The perioperative surgical home: An innovative, patient-centred and cost-effective perioperative care model

Perioperative care should involve a comprehensive evaluation of the patient, risk assessment of various complications, suggesting ways to reduce the complications, working on optimization of the patient’s chronic medical conditions and managing them through the perioperative period. Hospitalists have an important role to play as medical consultants in the perioperative period.

Lakshmi N. Prasad Ravipati

Papers

Update in Perioperative Medicine: Updates, Advances, Controversies in Perioperative Care