Anesthesiologists as perioperative hospitalists and outcomes in patients undergoing major urologic surgery: a historical prospective, comparative effectiveness study.
Publication/Presentation Date
1-1-2018
Abstract
BACKGROUND: Perioperative care has been identified as an area of wide variability in quality, with conflicting models, and involving multiple specialties. In 2014, the Loma Linda University Departments of Anesthesiology and Urology implemented a perioperative hospitalist service (PHS), consisting of anesthesiology-trained physicians, to co-manage patients for the entirety of their perioperative period. We hypothesized that implementation of this PHS model would result in an improvement in patient recovery.
METHODS: As a quality improvement (QI) initiative, the PHS service was formed of selected anesthesiologists who received training on the core competencies for hospitalist medicine. The service was implemented following a co-management agreement to medically manage patients undergoing major urologic procedures (prostatectomy, cystectomy, and nephrectomy). Impact was assessed by comparisons to data from the year prior to PHS service implementation. Data was compared with and without propensity matching. Primary outcome marker was a reduction in length of stay. Secondary outcome markers included complication rate, return of bowel function, number of consultations, reduction in total direct patient costs, and bed days saved.
RESULTS: Significant reductions in length of stay (
CONCLUSIONS: Anesthesiologists can safely function as perioperative hospitalists, providing appropriate medical management, and significantly improving both patient recovery and throughput.
Volume
7
First Page
13
Last Page
13
ISSN
2047-0525
Published In/Presented At
Stier, G., Ramsingh, D., Raval, R., Shih, G., Halverson, B., Austin, B., Soo, J., Ruckle, H., & Martin, R. (2018). Anesthesiologists as perioperative hospitalists and outcomes in patients undergoing major urologic surgery: a historical prospective, comparative effectiveness study. Perioperative medicine (London, England), 7, 13. https://doi.org/10.1186/s13741-018-0090-y
Disciplines
Medicine and Health Sciences
PubMedID
29951203
Department(s)
Department of Medicine
Document Type
Article