In hospitals that have re-engineered their surgical processes to break down silos and create an effective multidisciplinary approach to surgery, patient engagement and patient education tools have a much bigger impact on perioperative care. Hospitals that have successfully streamlined their surgical care to improve safety, patient satisfaction, clinician satisfaction, and health outcomes made change management their principal focus, and only then looked at their clinical protocols, technology, and tools. Changing the culture by breaking down silos between anesthesiologists, surgeons, nurses, and administrators make the biggest impact on raising the bar on quality and reducing the variability of outcomes.

Clinicians who have effectively implemented an enhanced recovery protocol for surgery are emphatic that their success had less to do with the clinical pathways and more to do with re-engineering the surgical process and building a multidisciplinary team.

At one large health system, they implemented only two steps of the more complex ERAS protocol— early ambulation and early alimentation— and spent the lion’s share of their planning getting buy-in and aligning all the surgical stakeholders on a vision and strategy (including metrics). Doing this helped them to create an effective process for communication and planning as well as a process to monitor and fine-tune the implementation. The results were stellar and led to the protocol was implemented at more than a dozen hospitals with more than 100 surgeons. Most importantly, the success was sustained over time.

Often a pilot initiative in the preoperative surgical home or enhanced recovery is successful and has compelling results when implemented in a single department, but that success does not often translate across the hospital or the health system because of lack of buy-in from leadership and alignment across the organization. Getting early buy-in from the executives and administrators from the hospital is critical to a pilot’s success to be implemented more broadly.


Want to learn more about creating a Perioperative Surgical Home (PSH)? Join us for our webinar, the Blueprints to Building a PSH on March 19, 2020, at 2 pm (EST) to get the how, what and why of building a PSH Planning for a successful PSH implementation and learn how to measure success, the lessons learned and recommendations.

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