The decision to launch the Perioperative Surgical Home model of comprehensive surgical patient care began when the American Society of Anesthesiologists realized that medically trained and licensed anesthesiologists are uniquely qualified to lead these PSH teams. This program serves as a national initiative, designed to improve the entire range of every surgical patient’s inpatient or out-patient experience.
A significant amount of time has been spent in the study, evaluation and development of standards for improved coordination of surgical patient care and recovery through higher quality management. Following continuity of care from the patient’s initial decision to have a surgical procedure, the pre-op/preparation, monitoring all phases during the procedure, recovery and follow-up treatments, the anesthesiologist performs a higher level of coordinated care and manages the progress of surgical patients like never before.
The Present Role of the Anesthesiologist with Communications and Monitoring Patients
The anesthesiologist consistently works with the intake nurses before surgery to establish the best course of anesthesia administration in accordance with each patient’s medical history, present stats and physical challenges and strengths.
It is the anesthesiologist who sets-up, administers and monitors drugs while monitoring their effects on the patient, and induces the appropriate level of unconsciousness through-out procedures. This specialized, critical-care physician also monitors the patient’s vital statistics during and after surgeries.
At the end of the procedure, it is the anesthesiologist who follows the patients as they come out of sedation, work with other attending doctors to insure correct treatment follow-ups, plus provides pain relief and alleviation of other symptoms during recovery. Anesthesiologists also spend time working with their patients in the emergency room, ICU, through-out labor stages, and consults with patients suffering from chronic pain.The anesthesiologist consistently works with the intake nurses before surgery to establish the best course of anesthesia administration in accordance with each patient’s medical history, present stats and physical challenges and strengths
Goals for Extending the Role of Anesthesiologists with the PSH Model
The ASA is working with Premier, Inc., to pro-actively re-design surgical patient care coordination during three phases of surgical care: preoperative, intra-operative, and postoperative. Mainly, their goals are to improve health, healthcare delivery, as well as significantly reducing treatment costs, by eliminating former variables in fragmented styles of perioperative care plans.
Some major waste eliminators include continuity of care that prevents duplicate lab and/or specialty testing orders, patients followed under one roof, without multiple independent billings for services, and more comprehensive care follow-up to eliminate post-operative emergency events.
Using anesthesiologists to supervise and evaluate the medical care of surgical patients is a direct link to improving post-operative morbidity and mortality mandates in all medical facilities. Increasing the role of physician anesthesiologists as perioperative physicians, and upgrading post-operative continuity provides the safest, highest quality of care that every surgical patient deserves.
Installation of the PSH model will not replace the surgeon’s patient care responsibilities, but utilize the abilities of the entire perioperative team which expands critical service to each patient. Fragmented medical care plans of the past risked undetected gaps in the patient’s expected care. This has been the root of increased percentage of mistakes, accidents and unnecessary care.
Utilization of this PSH Model Brings a Winning Solution to Surgical Patient Care
Achieving essential goals like expanding core knowledge, and broadening the scope of practice of the physician anesthesiologist is foremost in developing the PSH model. The next priority is improving patient satisfaction and standardization of healthcare resources. The use of medical optimization in advance, such as enhanced pre-surgical diet, supplements, and lab tests for pre-conditions, prepare each patient for the coming surgery. Postoperative pain control to alleviate anxiety, continued patient education and empowerment also contribute to effectively reducing instances of post-surgical complications.
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