Peri-operative care pathways: re-engineering care to achieve the ‘triple aim’
Peri-operative care pathways: re-engineering care to achieve the ‘triple aim’
Summary: Elective surgical pathways offer a particular opportunity to plan radical change in the way care is delivered, based on patient need rather than provider convenience. Peri-operative pathway redesign enables improved patient experience of care (including quality and satisfaction), population/public health, and healthcare value (outcome per unit of currency). Among physicians with the skills to work within peri-operative medicine, anaesthetists are well positioned to lead the re-engineering of such pathways. Re-engineered pre-operative pathways open up opportunities for intervention before surgery including shared decision-making, comorbidity management and collaborative behavioural change. Individualised, risk-adapted, intra-operative interventions will drive more reliable and consistent care. Risk-adapted postoperative care, particularly around transitions of care, has a significant role in improving value through peri-operative medicine. Improved integration with primary care providers offers the potential for minimising errors around transitions of care before and after surgery, as well as maximising opportunities for population health interventions, including lifestyle modification (e.g. activity/exercise, smoking and/or alcohol cessation), pain management and sleep medicine. Systematic data collection focused on quality improvement is essential to drive continuous clinical improvement and will be enabled by technological development in predictive analytics, systems modelling and artificial intelligence.
peri-operative medicine, pre-operative assessment, prehabilitation, process re-engineering, surgical care pathways
90-99
Grocott, M.P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Edwards, M.
590cde38-5395-40fd-833c-9e0622adada3
Mythen, M.G.
266ffcca-f8dd-49b4-abe4-0ffb035e2b35
Aronson, S.
f53411f5-bf77-4fed-99ed-be76f0f6e0c0
2 January 2019
Grocott, M.P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Edwards, M.
590cde38-5395-40fd-833c-9e0622adada3
Mythen, M.G.
266ffcca-f8dd-49b4-abe4-0ffb035e2b35
Aronson, S.
f53411f5-bf77-4fed-99ed-be76f0f6e0c0
Grocott, M.P.W., Edwards, M., Mythen, M.G. and Aronson, S.
(2019)
Peri-operative care pathways: re-engineering care to achieve the ‘triple aim’.
Anaesthesia, 74 (S1), .
(doi:10.1111/anae.14513).
Abstract
Summary: Elective surgical pathways offer a particular opportunity to plan radical change in the way care is delivered, based on patient need rather than provider convenience. Peri-operative pathway redesign enables improved patient experience of care (including quality and satisfaction), population/public health, and healthcare value (outcome per unit of currency). Among physicians with the skills to work within peri-operative medicine, anaesthetists are well positioned to lead the re-engineering of such pathways. Re-engineered pre-operative pathways open up opportunities for intervention before surgery including shared decision-making, comorbidity management and collaborative behavioural change. Individualised, risk-adapted, intra-operative interventions will drive more reliable and consistent care. Risk-adapted postoperative care, particularly around transitions of care, has a significant role in improving value through peri-operative medicine. Improved integration with primary care providers offers the potential for minimising errors around transitions of care before and after surgery, as well as maximising opportunities for population health interventions, including lifestyle modification (e.g. activity/exercise, smoking and/or alcohol cessation), pain management and sleep medicine. Systematic data collection focused on quality improvement is essential to drive continuous clinical improvement and will be enabled by technological development in predictive analytics, systems modelling and artificial intelligence.
Text
Perioperative-care-pathways_edited Smith 12 Sept 2018_MG_22-10-18
- Accepted Manuscript
More information
Accepted/In Press date: 20 October 2018
e-pub ahead of print date: 2 January 2019
Published date: 2 January 2019
Keywords:
peri-operative medicine, pre-operative assessment, prehabilitation, process re-engineering, surgical care pathways
Identifiers
Local EPrints ID: 427871
URI: http://eprints.soton.ac.uk/id/eprint/427871
ISSN: 0003-2409
PURE UUID: 55eed198-6c46-4e92-b5b1-29c789cad70b
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Date deposited: 30 Jan 2019 17:30
Last modified: 16 Mar 2024 07:31
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Contributors
Author:
M. Edwards
Author:
M.G. Mythen
Author:
S. Aronson
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