Being able to take better care of patients and be
successful in new payment models can go hand-in-hand. A new model of care implemented at TEAMHealth Anesthesia
at Tampa General Hospital in Tampa, Fla., does exactly this, revealed a new study.
The Perioperative Surgical Home (PSH) model of care helped decrease the number of tests, blood transfusions and length of time
in the hospital. It also helped in improving patients' pain management and
communication with physicians. The study was
presented at the ANESTHESIOLOGY® 2016 annual meeting.
‘The Perioperative Surgical Home (PSH) model of care helped decrease the number of tests, blood transfusions and hospital stay. It also helped in improving patients' pain management and communication with physicians.’
"Implementation of the core PSH evidenced-based practice
principles through physician leadership and redesign of the
perioperative process has become 'job one' across all of our practices
nationwide," said Sonya Pease, chief medical officer, TEAMHealth
Anesthesia. "Being able to take better care of patients and be
successful in new payment models can go hand-in-hand, this model of care
does exactly this."
In the study, researchers reviewed the medical records of 1,356
patients who had total knee, hip or shoulder joint replacement surgery. 50% of the patients received care under the PSH model, while
the other 50% did not.
Overall, they found a 9% decrease
in imaging tests; the average number of laboratory tests prior to
surgery decreased by 22%; blood transfusion requirements
decreased, with 87% fewer units of blood used per case; average
length of hospital stay decreased by slightly more than half a day; and
patient satisfaction improved, with patients reporting better pain
management and more effective physician communication.
"We took common sense ideas and implemented them," said Enrico
Camporesi, professor emeritus at the University of South Florida
and director of research, SE at TEAMHealth Anesthesia Research
"Patients were going for duplicate images because our systems
across institutions did not communicate," said Devanand Mangar,
chief of anesthesia at Tampa General Hospital and regional medical
director, TEAMHealth Anesthesia. "Protocols for blood transfusions
needed modification to limit unnecessary transfusion. Shifting from
continuous nerve blocks to spinal blocks as well as a focus on better
communication and more timely pain management consults realized overall
improvements for our patients."
The PSH is an innovative patient-centered, physician-led,
multidisciplinary team-based model of coordinated care spearheaded by
the American Society of Anesthesiologists. In the PSH, a patient's
entire surgical experience - preoperative, intraoperative and
post-discharge - is fully coordinated and treated as a continuum of
care. The PSH model emphasizes the cost-efficient use of resources and
patient shared decision-making.