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PERIOPERATIVE SURGICAL HOME | FROM PAGE 12
THE PERIOPERATIVE SURGICAL HOME TAKES A 5-PRONGED APPROACH TO HIGH-QUALITY, COORDINATED CARE:
1. PREOPERATIVE:Patient-centricoptimizationofevidence-basedstandard protocols, patient education and a multi-disciplinary care plan.
2. INTRAOPERATIVE: Uses evidence-based protocols combined with operations management, focused on reducing variation in care through enhanced recovery after
surgery (ERAS) protocols and goal-directed therapy.
3. POSTOPERATIVE: Engages evidence-based protocols through a team management approach focused on delivering the right level of care, prevention of complications and reduced variation.
4. POST-DISCHARGE: Transitioning the patient to the appropriate level of care for rehabilitation / return to function, plus educating patients and caregivers, and reducing variation in care.
5. METRICS: Measurements and supporting microsystems to scale quality improvements. Includes IT, decision support, case management support, pharmacy, blood bank, dietary recommendations, human resources, patient education and rehabilitation such as physical therapy. ■
PSH SURGICAL TARGETED OUTCOMES SHOULD RESULT IN A CUMULATIVE DECREASE IN:
↓ Cost per case
↓ Readmission rate
↓ Hospital length of stay
↓ Pain management sensitivity
↓ Complications
↑ And result in a cumulative increase in patient / customer satisfaction
THE PSH MODEL CONSISTS OF THE FOLLOWING KEY ASPECTS:
A PORTAL OF ENTRY TO THE PERIOPERATIVE CARE PATHWAY
STRATIFICATION AND MANAGEMENT OF PATIENT POPULATIONS ACCORDING TO RISK FACTORS
EVIDENCE-INFORMED, INTEGRATED CLINICAL CARE BEFORE, DURING, AND AFTER THE PROCEDURE
ONGOING MEASUREMENT AND IMPROVEMENT
Sources:
1. “From Heroism to Safe Design” Leveraging Technology. ASA® Anesthesiology 2014. Peter J. Pronovost, MD, PhD, George W. Bo-Linn, MD, MHA, Adam Sapirstein, MD
2. https://www.asahq.org/PSH
3. https://www.asahq.org/resources/perioperative-surgical-home
4. https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html
5. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26.html
6. https://innovation.cms.gov/initiatives/CJR
8. http://www.cepamerica.com/news-resources/perspectives-on-the-acute-care-continuum/august-2016/perioperative-surgical-home-market-share
9. http://www.anesthesiology.uci.edu/psh.shtml
10. http://www.sheppardhealthlaw.com/2015/01/articles/medicare/hhs-aims-to-tie-most-medicare-reimbursements-to-quality-by-2018/
ISSUE ONE | CONNECTED