Articles  |   September 2015
The Perioperative Surgical Home: Electronic Patient Assessment Tool
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Central and Peripheral Nervous Systems / Renal and Urinary Systems / Electrolyte Balance / Respiratory System / Technology / Equipment / Monitoring / Articles
Articles   |   September 2015
The Perioperative Surgical Home: Electronic Patient Assessment Tool
ASA Monitor 09 2015, Vol.79, 26-28.
ASA Monitor 09 2015, Vol.79, 26-28.
The overall aim of the Perioperative Surgical Home (PSH) model is to transform surgical care based on the triple aim suggested by Berwick in 2008. That is, improved clinical quality, enhanced patient experience and lower cost of medical care. The PSH involves early identification of patient medical problems, optimization prior to surgery, clinical pathways, reduced variability and perioperative management up to 30 days following surgery. As part as of the ongoing implementation of the PSH in the University of California, Irvine (UC Irvine Health), the PSH Information Technology group developed a package of Web apps to facilitate the preoperative screening process in order to identify patients requiring additional assessment prior to meeting their physician anesthesiologist on the day of surgery. The package of apps is called the Electronic Patient Assessment Tool (e-PAT). These Web apps make it easy for patients to enter their medical information and apply a set of clinical decision-support rules to suggest ASA Physical Status risk classification, postoperative risk of pulmonary and renal complications, postoperative nausea and vomiting (PONV) and postoperative delirium. In addition, the decision support logic suggests the appropriate preoperative evaluation for the planned surgery. Use of e-PAT and the associated assessment algorithms has enabled our group to consistently maintain the day of surgery cancellation rate under 2 percent within our institution.
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