Features  |   October 2014
Special Considerations for the Pediatric Perioperative Surgical Home: One Size Does Not Fit All
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Pediatric Anesthesia / Features
Features   |   October 2014
Special Considerations for the Pediatric Perioperative Surgical Home: One Size Does Not Fit All
ASA Monitor 10 2014, Vol.78, 34-36.
ASA Monitor 10 2014, Vol.78, 34-36.
Eight years ago in the 44th Emery A. Rovenstine Memorial Lecture, Mark A. Warner, M.D. posed this provocative question in his address to ASA: “Who better than anesthesiologists?”1  He also noted that there was an increasing demand for “providing care to children younger than 2 years of age in pediatric focused medical centers.” Since then, ASA has vigorously promoted the Perioperative Surgical Home (PSH), focusing on innovative, patient-centered and coordinated models of care. Two models of the PSH have been proposed and published based on a general hospital setting; however, the implementation of the PSH has not incorporated comparable pediatric models.2,3  The development of these models should consider the specific issues related to the general pediatric population, including the significant numbers of children with special health care needs. There is little doubt that the perioperative management of the pediatric patient differs from general anesthesia practice. Collaborative coordinated care models have been established to manage infants and children with multiple complex diseases using Patient/Family Centered Care Coordination paradigms.4  Furthermore, the Accreditation Council for Graduate Medical Education (ACGME) approved subspecialty fellowship programs to provide rigorous training environments for the current generation of pediatric anesthesiologists.5  Last year, the American Board of Anesthesiology established the first certification examination in pediatric anesthesiology. These demographic and oversight changes, coupled with the ongoing restructuring of traditional models of health care delivery, provide a unique opportunity for pediatric anesthesiologists to integrate their specific expertise to contribute to the care of the pediatric surgical patient.
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