title: An analysis of methodologies that can be used to validate if a perioperative surgical home improves the patient-centeredness, evidence-based practice, quality, safety, and value of patient care.
abstract: Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.
authors.affiliation: * Maurice S. Albin Professor, ‡ Resident, ‖ David H. Chestnut Professor, Department of Anesthesiology, School of Medicine, † Associate Professor, Department of Human Studies, School of Education, § Professor, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Vetter
authors.forename: Nataliya V
authors.initials: NV
authors.lastname: Ivankova
authors.forename: Lee A
authors.initials: LA
authors.lastname: Goeddel
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Pittet
mesh_terms: D015331:Cohort Studies; D003363:Cost Control; D055317:Evidence-Based Practice / Q000191:economics / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D005791:Patient Care / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data*; D061214:Patient Safety; D018802:Patient-Centered Care / Q000191:economics / Q000706:statistics & numerical data*; D019990:Perioperative Care / Q000191:economics / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012106:Research / Q000706:statistics & numerical data*; D012107:Research Design / Q000706:statistics & numerical data*; D016896:Treatment Outcome