title: The perioperative surgical home: An innovative, patient-centred and cost-effective perioperative care model.
abstract: Contrary to the intraoperative period, the current perioperative environment is known to be fragmented and expensive. One of the potential solutions to this problem is the newly proposed perioperative surgical home (PSH) model of care. The PSH is a patient-centred micro healthcare system, which begins at the time the decision for surgery is made, is continuous through the perioperative period and concludes 30 days after discharge from the hospital. The model is based on multidisciplinary involvement: coordination of care, consistent application of best evidence/best practice protocols, full transparency with continuous monitoring and reporting of safety, quality, and cost data to optimize and decrease variation in care practices. To reduce said variation in care, the entire continuum of the perioperative process must evolve into a unique care environment handled by one perioperative team and coordinated by a leader. Anaesthesiologists are ideally positioned to lead this new model and thus significantly contribute to the highest standards in transitional medicine. The unique characteristics that place Anaesthesiologists in this framework include their systematic role in hospitals (as coordinators between patients/medical staff and institutions), the culture of safety and health care metrics innate to the specialty, and a significant role in the preoperative evaluation and counselling process, making them ideal leaders in perioperative medicine.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Clinique de la Sauvegarde, 69009 Lyon, France; Université Lyon 1, EA4169, SFR Lyon-Est Santé, Inserm US 7, CNRS UMS 3453, 69000 Lyon, France. Electronic address: oldesebbe@yahoo.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Desebbe
authors.affiliation: Department of Anaesthesiology and Intensive Care, Clinique de la Sauvegarde, 69009 Lyon, France. Electronic address: lanzthomas@gmail.com.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lanz
authors.affiliation: Department of Anesthesiology & Perioperative Care, University of California Irvine, UC Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA. Electronic address: zkain@uci.edu.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Kain
authors.affiliation: Department of Anesthesiology & Perioperative Care, University of California Irvine, UC Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA. Electronic address: mcanness@uci.edu.
authors.forename: Maxime
authors.initials: M
authors.lastname: Cannesson
mesh_terms: D000072080:Anesthesiologists; D000776:Anesthesiology / Q000639:trends; D003362:Cost-Benefit Analysis; D006801:Humans; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D018802:Patient-Centered Care / Q000191:economics / Q000379:methods*; D019990:Perioperative Care / Q000191:economics / Q000379:methods*
keywords: Hospital care; Perioperative surgical home