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New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders. By comparison, ERAS is a series of well-defined clinical protocols that do not extend beyond the episode of surgical care. As an added aspect of its benefits, PSH also helps to control costs by decreasing unnecessary testing and cancellations, and allowing for more OR access by inpatients.

Competing Interests: Conflict of interest Nothing to declare

Titel:	Perioperative Surgical Home. Meeting tomorrow's challenges.
Autor/in / Beteiligte Person:	Nicolescu, TO
Zeitschrift:	Romanian journal of anaesthesia and intensive care, Jg. 23 (2016-10-01), Heft 2, S. 141-147
Veröffentlichung:	<2018>- : Warsaw, Poland : Sciendo ; <i>Original Publication</i>: Cluj-Napoca : Clusium, [2014]-, 2016
Medientyp:	academicJournal
ISSN:	2392-7518 (print)
DOI:	10.21454/rjaic.7518/232.sho
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Review Language: English [Rom J Anaesth Intensive Care] 2016 Oct; Vol. 23 (2), pp. 141-147. References: Vasc Health Risk Manag. 2015 Jul 01;11:379-85. (PMID: 26170688) ; Natl Health Stat Report. 2009 Jan 28;(11):1-25. (PMID: 19294964) ; Am J Med. 1998 Nov;105(5):380-4. (PMID: 9831421) ; Am J Geriatr Psychiatry. 2013 Oct;21(10):946-56. (PMID: 23659900) ; World J Gastroenterol. 2012 Jan 21;18(3):205-11. (PMID: 22294823) ; J Thorac Cardiovasc Surg. 2001 Aug;122(2):278-86. (PMID: 11479500) ; Can Urol Assoc J. 2014 Nov;8(11-12):E884-7. (PMID: 25485023) ; Anesth Analg. 2014 May;118(5):1126-30. (PMID: 24781578) ; BMC Anesthesiol. 2013 Mar 14;13:6. (PMID: 23497277) ; Best Pract Res Clin Anaesthesiol. 2007 Jun;21(2):271-89. (PMID: 17650777) ; Pain Med. 2015 Sep;16(9):1666-72. (PMID: 26177700) ; Dis Colon Rectum. 2009 Nov;52(11):1848-53. (PMID: 19966631) ; Anaesthesia. 2015 Jan;70 Suppl 1:20-8, e6-8. (PMID: 25440391) ; J R Soc Med. 2013 Jul;106(7):269-77. (PMID: 23759887) ; J Arthroplasty. 2013 Sep;28(8 Suppl):34-7. (PMID: 23896359) ; Implement Sci. 2010 Nov 17;5:88. (PMID: 21083908) ; BMJ Open. 2016 Feb 02;6(2):e009857. (PMID: 26839013) ; Ann Intensive Care. 2011 Mar 21;1(1):1. (PMID: 21906322) ; Ann Surg. 2016 Mar;263(3):465-76. (PMID: 26445470) ; Br J Anaesth. 2013 Apr;110(4):510-7. (PMID: 23447502) ; Health Policy. 2011 Oct;102(2-3):214-22. (PMID: 21680044) ; N Engl J Med. 2005 Jul 28;353(4):349-61. (PMID: 16049209) ; J Rural Health. 2009 Winter;25(1):62-9. (PMID: 19166563) ; Transfusion. 2011 Jan;51(1):118-24. (PMID: 20624257) Contributed Indexing: Keywords: blood and fluid management; enhanced recovery; pain control; perioperative surgical home ; Local Abstract: [Publisher, Romanian; Moldavian; Moldovan] Noile modele de servicii medicale propun o varietate de modificări pentru anestezişti, de la nevoia de a îmbunătăţi calitatea serviciilor la restrângerea costurilor, dezvoltând astfel conceptul de “Perioperative Surgical Home” (PSH).Creat după modelul intensificării recuperării postoperatorii (ERAS), conceptul de PSH face un pas mai departe şi propune ca îngrijirea coordonată a pacientului, începută o dată cu decizia intervenţiei chirurgicale, să continue timp de 30 de zile postoperator, şi să fie precedată de o judicioasă evaluare preoperatorie bazată pe dovezile stabilite în literatura de specialitate.PSH se bazează de asemenea în mare măsură pe ingineriile de strategie importate, cum ar fi metodologiile Lean Six Sigma, şi astfel implică participarea activă a tuturor organizaţiilor administrative interesate direct.Prin comparaţie, ERAS reprezintă o sumă de protocoale clinice bine definite care nu se referă şi la perioada care depăşeşte episodul intervenţiei chirurgicale. Ca un beneficiu adiţional PSH determină o îmbunătăţire a controlului costurilor prin scăderea testelor care nu sunt necesare şi a contramandărilor de intervenţii chirurgicale determinând astfel un acces sporit în sălile de operaţii pentru pacienţii internaţi. Entry Date(s): Date Created: 20170916 Latest Revision: 20201001 Update Code: 20231215 PubMed Central ID: PMC5505387

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Perioperative Surgical Home. Meeting tomorrow's challenges.