With the PSH model, the patient’s experience of care is coordinated by a Director of Perioperative Services, additional Surgical Home Leadership, and supportive personal which constitute an interdisciplinary team. The expected metrics includes improved operational efficiencies, decreased resource utilization, a reduction in length of stay and readmission, and a decrease in complications and mortality---resulting in a better patient experience of care.
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This new patient-centered model is designed to achieve the triple aim of improving health, improving the delivery of healthcare, and reducing the cost of care. These goals will be met through shared decision-making and seamless continuity of care for the surgical patient, from the decision for surgery through recovery, discharge, and beyond. Each patient will receive the right care, at the right place, and the right time.
Driven by disruptive public policy, medicine is transitioning from a fee-for-service payment system to a value-based system with alternative models of payment as the lever of change. Here-to-fore, the practice of anesthesiology has focused on the application of medical science within a discrete clinical microsystem where the patient and the anesthesiologist came together to produce a specific healthcare outcome. This approach, although producing superb results within the intraoperative microsystem, has resulted in fragmented and a diminished patient experience througout the entire surgical or procedural episode of care.
Too often, perioperative care plans are variable and fragmented. The decision of the need for surgery often disconnects patients from their typical medical care. Surgical patients may experience lapses in care, duplication of tests, and preventable harm. Costs rise, complications occur, physicians and other healthcare team members are frustrated, and the patient and family endure a lower-quality experience of care. Similarly, the transition from perioperative surgical care to medical home or primary care may be accompanied by lapses. Accordingly, the American Society of Anesthesiologists recognizes that innovation must occur within the patient’s episode of surgical/procedural care, and a new model of perioperative care must be developed in our patient’s best interests.
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