The Perioperative Surgical Home

What is it?

Periop Surgical HomeThe Perioperative Surgical Home (PSH) is a new model for perioperative care delivery being encouraged and advanced by the American Society of Anesthesiologists (ASA). While the model is still evolving, the ASA has put forth the following description: “The Perioperative Surgical Home (PSH) strives to achieve the triple aim of better health, better healthcare, and reduced expenditures for all patients undergoing surgery and invasive procedures. As a patient-centered, physician-led, interdisciplinary and team-based system, the PSH coordinates care from pre-procedure assessment through the acute care episode, recovery, and post-acute care. The goal is for each perioperative patient to receive the right care at the right place and at the right time, with better patient satisfaction, fewer complications, and decreased costs.” 1

Why is it gaining traction?

The ASA’s motivation for the development of the PSH has been to address “deficiencies and weaknesses in a patient’s surgical care experience”. Deficiencies and Weaknesses such as: variations in practice, costs and outcomes; lack of coordination of care, collaboration, and communication among perioperative healthcare professionals; and lack of transparency, patient-centeredness/engagement, and shared decision making during the perioperative journey.  The PSH is seen as a viable solution for hospitals and anesthesia providers to achieve the “triple aim” of better health outcomes, a better patient experience, at a lower cost and is designed to be more in-line with value based reimbursement models and the transition to pay for performance.

Some of the Potential Benefits
Check Mark Improved quality and safety
Check Mark Increased collaboration
Check Mark Improved patient satisfaction
Check Mark Enhanced team-based care models
Check Mark Advancement of standardization and use of evidence based protocols
Check Mark Decreased surgical delays and cancellations
Check Mark Quicker surgical recovery; decreased hospital length of stay & readmissions

Where to begin?

Periop JourneyAs you can imagine, establishing a Perioperative Surgical Home is a significant undertaking. It requires education, preparation, negotiation, transparency, project planning, physician involvement and collaboration.

Educate yourself (asahq.org is a great place to start) and begin to discuss the concept with hospital leadership and the anesthesia providers (the concept will not work without anesthesia’s commitment and involvement).  From there you can consult with organizations that have successfully implemented this model of care, consider emerging technologies that support/advance the concept (and potentially reduce ongoing burden on the anesthesia providers). 

If all indications are that the PSH appears to be a possible solution for your organization, you should then establish a formal project, conduct a detailed assessment of readiness, continue to educate yourselves and peers on the concept, and assess financial costs and reimbursement implications.

As with most transformational healthcare projects, successful implementation of a PSH will require physician champions, executive endorsement and support, supportive technologies (and reliable data), strong leadership, a culture change and a desire to embrace the patient-centered care methodology.

Interested in learning more?

Just give us a call, or drop us an email we would be glad to share more detailed information and would be happy to discuss emerging technologies and services available to support the model (and which add minimal additional burden on the anesthesia providers).

 1 “psh-fact-sheet-final” accessed via http://www.asahq.org ‘s Resources tab on 8/12/2015