Comprehensive patient-centered perioperative care: another step towards expanding horizons in anesthesiology

  • Jaime Jaramillo Mejía a. Fondo Solidario Para Auxilio en Caso de Demanda (FEPASDE), Bogotá, Colombia. b. Colombian Society of Anaesthesiology and Resuscitation (S.C.A.R.E.), Bogota, Colombia. c. MEDT SAS - Specialised Pain and Work Clinic, Bogotá, Colombia.
Keywords: Anesthesiology, Perioperative Period, Competency-Based Education, Education, Social resposibility

Abstract

We must change the current perioperative care model and expand the horizons of our specialty, as the results are unsatisfactory, health systems are unviable, and an imminent crisis is predicted. Although the contributions made by anesthetists have improved the safety of care and have contributed to increase the life expectancy and the quality of life of the population, it is necessary to adopt a comprehensive, patient-centered care model. This involves adapting to new settings of clinical practice, extending anesthetist intervention times, and rethinking the professional competencies that must be demonstrated by those who will practice in the near future. Therefore, we must identify our training deficiencies and start working immediately on overcoming them. The objective of this article is to reflect on the problems of the current model, the solutions proposed by the new models and the successes, difficulties, and opportunities that have been observed during its implementation.

References

1. National Health Service (UK) ImprovementEnhanced recovery partnership programme - fulfilling the potential: a better journey for patients and a better deal for the NHS. 2012;National Health Service (UK) Improvement, Leicester:[Consulted 2017 Nov 29]. Available at: http://www.qihub.scot.nhs.uk/media/582955/nhs%20improving%20quaHty%20in%20collaboration%20wi1h%20nhs% 20england%20-%20enhanced%20recovery%20care%20pathway% 20publication.pdf.

2. Arend J, Tsang-Quinn J, Levine C, et al. The patient centered medical home: history, components, and review of the evidence. Mt Sinai J Med 2012;79:433-450.

3. Committee on Quality Health Care in America, Institute of Medicine Crossing the quality chasm: a new health system for the 21st century. 2001;National Academy Press, Washington: [Consulted 2017 Nov 29]. Available at: https://www.nap.edu/catalog/10027/crossing-the-quality-chasm-a-new-health-system-for-the.

4. Jammer IB, Wickboldt N, Sander M, et al. Standards for definitions and use ofoutcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions. Eur J Anaesthesiol 2014;32:88-105.

5. Lee A, Kerridge RK, Chui PT, et al. Perioperative systems as a quality model of perioperative medicine and surgical care. Health Policy 2011;102:214-222.

6. Vollmer CM, Pratt W, Vanounou T, et al. Quality assessment in high-acuity surgery: volume and mortality are not enough. Arch Surg 2007;142:371-380.

7. Kehlet H, Mythen M. Why is the surgical high-risk patient still at risk? Br J Anaesth 2011;106:289-291.

8. Lee CN, Ko CY. Beyond outcomes. The appropriateness of surgical care. JAMA 2009;302:1580-1581.

9. Williams J. A new road map for healthcare business success. Healthc Financ Manage 2011;65:62-69.

10. Bohmer RMJ. Fixing health care on the front lines. Harv Bus Rev 2010;88:62-69.

11. Bohmer RM. The four habits of high-value health care organizations. N Engl J Med 2011;365:2045-2047.

12. Silber JH, Kennedy SK, Even-Shoshan O, et al. Anesthesiologist direction and patient out-comes. Anesthesiology 2000;93:152-163.

13. Sessler DI. Long-term consequences of anesthetic management. Anesthesiology 2009;111:1-4.

14. Heidegger T, Saal D, Nubling M. Patient satisfaction with anaesthesia - Part 1: Satisfaction as part of outcome - and what satisfies patients. Anaesthesia 2013;68:1165-1172.

15. Smith A. In search of excellence in anesthesiology. Anesthesiology 2009;110:4-5.

16. Smith AF, Glavin R, Greaves JD. Defining excellence in anaesthesia: the role of personal qualities and practice environment. Br J Anaesth 2011;106:38-43.

17. Glavin RJ. Excellence in anesthesiology. The role of nontechnical skills. Anesthesiology 2009;110:201-203.

18. Larsson J. Studying tacit knowledge in anesthesiology. A role for qualitative research. Anesthesiology 2009;110:443-444.

19. Cannesson M, Ani F, Mythen MM, et al. Anesthesiology and perioperative medicine around the world: different names, same goals. Br J Anaesth 2015;114:8-9.

20. Bowyer A, Jakobsson J, Ljungqvist O, et al. A review of the scope and measurement of postoperative quality of recovery. Anaesthesia 2014;69:1266-1278.

21. Weston AD, Hood L. Systems biology, proteomics, and the future of health care: toward predictive, preventative, and personalised medicine. J Proteome Res 2004;3:179-196.

22. Avidan MS, Evers AS. Longnecker DE, Brown DL, Newman MF, et al. The scope and future of anesthesia practice. In principles and practice of anesthesiology. Anesthesiology McGraw-Hill, New York:2008;12-19.

23. Tetzlaff JE. Professionalism in anesthesiology ‘What Is It?’ or ‘I Know It When I See It’. Anesthesiology 2009;110:700-702.

24. Lindahl SG. Future anesthesiologist will be as much outside as inside operating theaters. Acta Anaesthesiol Scand 2000;44: 906-909.

25. Prielipp RC, Morell RC, Coursin DB, et al. The future of anesthesiology: should the perioperative surgical home redefine us? Anesth Analg 2015;120:1142-1148.

26. Rock P. The future of anesthesiology is perioperative medicine. Anesthesiol Clin 2000;18:495-513.

27. Suzuki E. Atención quirúrgica: un servicio que se subvalora en los sistemas de salud. Datos de libre acceso. Página WEB. [Cited 2017 Dic 19]. Available at: https://datos.bancomundial.org/.

28. Sisko AM, Truffer CJ, Keehan SP, et al. National health spending projections: the estimated impact of reform through. Health Aff 2010;29:1933-1941.

29. Lee TH, Cosgrove T. Engaging doctors in the health care revolution. Harv Bus Rev 2014;92:104-111.

30. Department of Health The NHS quality, innovation, productivity and preventions challenge: an introduction for clinicians. 2010; Department of Health, London:[Consulted 2017 Nov 29]. Available at: http://webarchive.nationalarchives.gov.uk/20130124054011/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113807.pdf.

31. Findlay G, Goodwin A, Protopappa K, et al. Knowing the risk: a review of the peri-operative care of surgical patients. 2011; National Confidential Enquiry into Patient Outcome and Death, London: [Consulted 2017 Nov 29]. Available at: http://www.ncepod.org.uk/2011report2/downloads/POC_fullreport.pdf.

32. Kwok AC, Semel ME, Lipsitz SR, et al. The intensity and variation of surgical care at the end of life: a retrospective cohort study. Lancet 2011;378:1408-1413. [Consulted 2017 Nov 29]. Available at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61268-3/fulltext.

33. Williamson C. Towards the emancipation of patients: patients' experiences and the patient movement. E-Book. 2010;PolicyPress, Bristol:[Consulted 2017 Nov 29]. Available at: http://opacperpus.jogjakota.go.id/digilib_2015/files/previews/99606d143736b551d5fc77432025467b.pdf.

34. Gaba DM. Anaesthesiology as a model for patient safety in health care. BMJ 2000;320:785-788.

35. Newman MF, Mathew JP, Aronson S. The evolution of anesthesiology and perioperative medicine. Anesthesiology 2013;118:1005-1007.

36. American Society of Anesthesiologists. Perioperative surgical home. Pagina WEB. [Cited 2017 Nov 29]. Available at: https://www.asahq.org/psh.

37. Payne PR, Marsh CB. Towards a ‘4I’ approach to personalised healthcare. Clin Transl Med 2012;1:14.

38. Napolitano LM. Standardization of perioperative management: clinical pathways. Surg Clin North Am 2005;85:1321-1327.

39. Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS*) society recommendations. World J Surg 2013;37:259-284.

40. TR, Goeddel LA, Boudreaux AM, et al. The perioperative surgical home: how can it make the case so everyone wins? BMC Anesthesiol 2013;13:2-11.

41. Fleisher LA. Improving perioperative outcomes: my journey into risk, patient preferences, guidelines, and performance measures: ninth honorary FAER research lecture. Anesthesiology 2010;112: 794-801.

42. Anaesthesia Perioperative Care Network and Surgical Services TaskforcePerioperative Toolkit. 2016;Anaesthesia Perioperative Care Network and Surgical Services Taskforce, Sydney:[Consulted 2017 Nov 29]. Available at: https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0010/342685/The_Perioperative_Toolkit.pdf.

43. Saunders DI, Murray D, Pichel AC, et al. Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network. Br J Anaesth 2012;109:368-375.

44. Greco M, Capretti G, Beretta L, et al. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg 2014;38:1531-1541.

45. Kash BA, Zhang Y, Cline KM, et al. The Perioperative Surgical Home (PSH): a comprehensive review of us and non-us studies shows predominantly positive quality and cost outcomes. Milbank Q 2014;92:796-821.

46. Warner MA, Apfelbaum JL. The perioperative surgical home: a response to a presumed burning platform or a thoughtful expansion of anesthesiology? Anesth Analg 2015;120:1149-1151.

47. Velázquez J, Vargas M. Avances en la implementación del protocolo ERAS/ACERTO en Latinoamérica. [Cited 2017 Dic 19]. Available at: http://www.utmn.com.ve/pdf/eras_acerto_latinoamerica.pdf.

48. Zarate E. Medicina perioperatoria ¿es hora del cambio? Acercándonos al paciente ERAS en la Clínica Reina Sofía. Conferencia. abril 06 de 2016. [Cited 2017 Dic 19]. Available at: http://www.anestesiaweb2.com/detalle-video.php?IDVideo=346.

49. Butterworth JF, Green JA. The anesthesiologist-directed perioperative surgical home: a great idea that will succeed only if it is embraced by hospital administrators and surgeons. Anesth Analg 2014;118:896-897.

50. Dexter F, Wachtel RE. Strategies for net cost reductions with the expanded role and expertise of anesthesiologists in the perioperative surgical home. Anesth Analg 2014;118:1062-1071.
How to Cite
1.
Jaramillo Mejía J. Comprehensive patient-centered perioperative care: another step towards expanding horizons in anesthesiology. Colomb. J. Anesthesiol. [Internet]. 2018 Jul. 1 [cited 2024 Apr. 23];46(3):242-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/537

Downloads

Download data is not yet available.
Published
2018-07-01
How to Cite
1.
Jaramillo Mejía J. Comprehensive patient-centered perioperative care: another step towards expanding horizons in anesthesiology. Colomb. J. Anesthesiol. [Internet]. 2018 Jul. 1 [cited 2024 Apr. 23];46(3):242-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/537
Section
Essay

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: