Nicolescu Teodora O
Department of Anesthesiology, Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Rom J Anaesth Intensive Care. 2016 Oct;23(2):141-147. doi: 10.21454/rjaic.7518/232.sho.
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders. By comparison, ERAS is a series of well-defined clinical protocols that do not extend beyond the episode of surgical care. As an added aspect of its benefits, PSH also helps to control costs by decreasing unnecessary testing and cancellations, and allowing for more OR access by inpatients.
新的医疗模式给麻醉医生带来了各种各样的变化，从提高质量的需求到成本控制：因此，围手术期外科之家（PSH）的概念应运而生。PSH以英国的术后加速康复（ERAS）为蓝本，更进一步，从为患者做出手术决定之时起，协调护理直至术后多达30天，采用基于循证的合理方法进行审慎的术前检查。围手术期外科之家还严重依赖于引入的工程策略，如使用精益六西格玛方法，并涉及所有利益相关者的积极参与。相比之下，ERAS是一系列明确的临床方案，不会超出手术护理阶段。作为其益处的一个附加方面，PSH还通过减少不必要的检查和取消手术，并让住院患者有更多机会使用手术室，来帮助控制成本。
