title: Enhanced recovery after surgery, perioperative medicine, and the perioperative surgical home: current state and future implications for education and training.
abstract: OBJECTIVE
  The purpose of this review is to summarize the current state of perioperative medicine, including the perioperative surgical home (PSH) and enhanced recovery after surgery pathways (ERAS) as well as the educational implications of these concepts for current and future anesthesiology trainees.
  
  
  RESULTS
  Although there is significant, ongoing discussion surrounding the structural concept of the PSH, there remains little clinical evidence to support its development. On the other hand, publications surrounding ERAS principles continue to show clinical benefit in reducing length of stay, cost, and perioperative complications for a variety of surgical populations. In this milieu, perioperative medicine is increasingly being recognized as its own specialty in perioperative care that encompasses, but is larger than, ERAS.
  
  
  CONCLUSIONS
  There is sufficient evidence to support widespread adoption of ERAS principles, although the specifics of local implementation may vary from site to site. There is significant uncertainty as to what the PSH actually is. However, perioperative medicine is a defined specialty in medicine that overlaps significantly with anesthesiology core training and practice and will be a significant focus in future education, research, and clinical care provided by anesthesiologists.
authors.affiliation: aVanderbilt Perioperative Anesthesia Service bTennessee Valley Healthcare System, Veteran's Affairs Hospital Perioperative Anesthesia Service, Division of Anesthesiology and Critical Care Medicine, Department of Anesthesiology cDepartment of Anesthesiology, Center for Innovation in Perioperative Health, Education, and Research (CIPHER), Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: King
authors.forename: Bret D
authors.initials: BD
authors.lastname: Alvis
authors.forename: Matthew D
authors.initials: MD
authors.lastname: McEvoy
mesh_terms: D000776:Anesthesiology / Q000193:education*; D004501:Education, Medical; D006801:Humans; D018802:Patient-Centered Care / Q000379:methods*; D019990:Perioperative Care / Q000639:trends*; D020127:Recovery of Function