Clinical Publications | Case Studies | Concept Papers

Total Joint Replacement Perioperative Surgical Home Program: 2-Year Follow-Up

Previously, our group successfully established one of the nation’s first Perioperative Surgical Homes (PSHs) aimed at coordinating services to patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). As we now focus on extending the PSH to other service lines within the hospital, the long-term sustainability of this practice model is an important factor to consider moving forward.

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A case management report: a collaborative perioperative surgical home paradigm and the reduction of total joint arthroplasty readmissions

As healthcare evolves to emphasize value over volume, it is integral to invest efforts in longitudinal patient outcomes including patient disposition subsequent to hospital discharge. As outlined by this case management report, the PSH provides an institution-led means to implement a series of care initiatives that optimize the important metric of readmission following TJA, potentially adding further value to patients, surgical colleagues, and health systems.

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The use of enhanced recovery after surgery (ERAS) principles in Scottish orthopaedic units—an implementation and follow-up at 1 year, 2010–2011: a report from the Musculoskeletal Audit, Scotland

A clinically guided and nationally supported process has proven highly successful in achieving a further uptake of enhanced recovery principles after lower limb arthroplasty in Scotland, which has resulted in clinical benefits to patients and reduced length of hospital stay.

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Reduced Length of Hospital Stay in Colorectal Surgery after Implementation of an Enhanced Recovery Protocol

Implementation of an enhanced recovery protocol for colorectal surgery at a tertiary medical center was associated with a significantly reduced LOS and incidence of urinary tract infection. This is consistent with that of other studies in the literature and suggests that enhanced recovery programs could be implemented successfully and should be considered in U.S. hospitals.

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Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERASÒ) Society Recommendations

This review aims to present a consensus for optimal perioperative care in rectal/pelvic surgery, and to provide graded recommendations for items for an evidenced-based enhanced recovery protocol.

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Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERASÒ) Society Recommendations

This review aims to present a consensus for optimal perioperative care in colonic surgery and to provide graded recommendations for items for an evidenced-based enhanced perioperative protocol.

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Implementation of a Total Joint Replacement-Focused Perioperative Surgical Home: A Management
Case Report

The perioperative setting in the United States is noted for variable and fragmented care that increases the chance for errors and adverse outcomes as well as the overall cost of perioperative care. Recently, the American Society of Anesthesiologists put forward the Perioperative Surgical Home (PSH) concept as a potential solution to this problem. Although the PSH concept has been described previously, ”real-life“ implementation of this new model has not been reported.

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Outcomes of a Joint Replacement Surgical Home Model Clinical Pathway

Optimizing perioperative care to provide maximum benefit at minimum cost may be best achieved using a perioperative clinical pathway (PCP). Using our joint replacement surgical home (JSH) model PCP, we examined length of stay (LOS) following total joint arthroplasty (TJA) to evaluate patient care optimization.

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Practice and Outcomes of the Perioperative Surgical Home in a California Integrated Delivery System

In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente).

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The Pain Management and the Perioperative Surgical Home: Getting the Desired Outcome Right

In this issue of Regional Anesthesia and Pain Medicine, Grevstad et al present the results of a study comparing quadriceps strength after total knee arthroplasty (TKA) after either a single-injection femoral nerve block or a single-injection adductor canal block (ACB). The need is clear to establish an effective and reliable analgesic protocol that can effectively manage these patients with maximal efficacy and minimal side effects, and this study is another step forward in this effort.

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The perioperative management of patients with coronary artery stents: surveying the clinical stakeholders and arriving at a consensus regarding optimal care

The perioperative management of patients with a coronary artery stent is a major patient safety issue currently confronting clinicians. Surgery on a patient on antiplatelet therapy creates the following dilemma: is it better to withdraw the drugs and reduce the hemorrhagic risk or to maintain them and reduce the risk of a myocardial ischemic event?

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