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Smoothing out the ride for surgical patients

Bruce Waxman examines the drivers of change in perioperative care and the effects on patient outcomes

Whether a patient is having an elective or emergency procedure, ideally their journey will follow a pathway that has been mapped out from the time of entering the hospital until their discharge summary is generated.

Recent changes in perioperative patient management have been described as a “paradigm” shift in surgical care — from traditional models (largely dictated by individual surgeons or surgical units) to a multidisciplinary team approach (including planned protocols, policies and guidelines with accountability governed by audit and peer review, the outcomes of which are used to formulate recommendations that effect change).1 The driver is a synergy between a quest for improving quality and safety and the desire to be more efficient with diminishing resources — where the objective is to reduce patient morbidity and mortality.

Here, I outline an ideal model of care — although, even with the best intentions, pragmatic deviations can occur. While it is most relevant to Australia, similar models exist overseas.2