Letter to the Editor  |   April 2016
Perioperative Surgical Home: Our Future, or Just a Fantasy?
Author Affiliations
  • Mark H. Zornow, M.D.
    Portland, Oregon
Article Information
Letter to the Editor
Letter to the Editor   |   April 2016
Perioperative Surgical Home: Our Future, or Just a Fantasy?
ASA Monitor 04 2016, Vol.80, 61-62.
ASA Monitor 04 2016, Vol.80, 61-62.
The concept of the Perioperative Surgical Home (PSH) has been discussed for more than a decade.1  But very fundamental questions remain. What, specifically, is it? What would it mean for the average anesthesiologist providing intraoperative care or running a pain management clinic? Do we, as anesthesiologists, really have the expertise or interest in providing pre- and postoperative care for chronically ill patients? Who would pay us to do any of this?
Despite the lack of answers to these most basic of questions, ASA and various leaders in our specialty have endorsed the concept of the PSH. In 2012, ASA created the Committee on Future Models of Anesthesia Practice. By 2013, this committee had generated a white paper on the PSH. They characterized the PSH as “a patient-centered and physician-led, inter-disciplinary and team-based system, the PSH coordinates care from pre-procedure assessment through the acute care episode, recovery, and post-acute care” with the goals of improving outcomes, providing a better experience for the patient, and reducing costs.2  All of this sounds very noble and desirable, but how will it be accomplished? One theme that frequently recurs in articles on this topic is the need to reduce variability in patient care. Authors have suggested various approaches to achieving this goal, including implementing Standardized Clinical Assessment and Management Plans (SCAMPS), integrated care plans, Enhanced Recovery After Surgery (ERAS) protocols and creation of a Personalized Care Matrix (PCM) that is “created by the amalgamation of all the standardized elements of a surgical procedure-specific integrated care pathway and applicable condition-specific SCAMPS.” 3 
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