title: Design and Implementation of a Perioperative Surgical Home at a Veterans Affairs Hospital.
abstract: The innovative Perioperative Surgical Home model aims to optimize the outcomes of surgical patients by leveraging the expertise and leadership of physician anesthesiologists, but there is a paucity of practical examples to follow. Veterans Affairs health care, the largest integrated system in the United States, may be the ideal environment in which to explore this model. We present our experience implementing Perioperative Surgical Home at one tertiary care university-affiliated Veterans Affairs hospital. This process involved initiating consistent postoperative patient follow-up beyond the postanesthesia care unit, a focus on improving in-hospital acute pain management, creation of an accessible database to track outcomes, developing new clinical pathways, and recruiting additional staff. Today, our Perioperative Surgical Home facilitates communication between various services involved in the care of surgical patients, monitoring of patient outcomes, and continuous process improvement.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Tessa L
authors.initials: TL
authors.lastname: Walters
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Howard
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Kou
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bertaccini
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: T Kyle
authors.initials: TK
authors.lastname: Harrison
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: T Edward
authors.initials: TE
authors.lastname: Kim
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Audrey
authors.initials: A
authors.lastname: Shafer
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Brun
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Funck
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Siegel
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Stary
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA Stanford University School of Medicine, Palo Alto, CA, USA emariano@stanford.edu.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Mariano
mesh_terms: D006787:Hospitals, Veterans; D006801:Humans; D059408:Pain Management; D019990:Perioperative Care; D063128:Tertiary Health Care
keywords: anesthesiology; outcomes; perioperative medicine; perioperative surgical home; process improvement; quality improvement; surgery