PSH improves outcomes in elderly, children

Editor's Note

The Perioperative Surgical Home (PSH) model of care was successful in improving quality of care and outcomes in elderly hip fracture patients and children having cardiac surgery in two studies presented October 14 at the Anesthesiology 2018 annual meeting in San Francisco.

One study compared 308 hip fracture patients who had surgery before the PSH service line was created and 1,170 who were treated after the PSH was implemented. After implementation, time spent going from the emergency department to the OR dropped from 48 to 34 hours and length of stay decreased from 8.12 to 6.12 days. Readmissions dropped from 12.36% to 9.9%.

The second study compared 135 children having cardiac surgery after PSH implementation and 150 who had surgery before implementation. After implementation, there was a reduction in overall hospital (from 174 to 127 hours) and ICU (from 75 to 73) length of stay, and 92% of children had their breathing tubes removed within 18 hours, compared to 86% before implementation.

The PSH is a patient-centered, physician-led, interdisciplinary team-based system of coordinated care created by the American Society of Anesthesiologists that spans the entire surgical episode from the decision to have surgery to discharge and beyond.