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Creation and Execution of a Novel Anesthesia Perioperative Care Service at a Veterans Affairs Hospital

Alvis, Bret D. MD*†; King, Adam B. MD*†; Pandharipande, Pratik P. MD, MSCI*†; Weavind, Liza M. MD*†; Avila, Katelin NP; Leisy, Philip J. MD*†; Ajmal, Muhammad MD§; McHugh, Michael MD; Keegan, Kirk A. MD¶#; Baker, David A. MD, MBA**; Walia, Ann MD*†; Hughes, Christopher G. MD*†

doi: 10.1213/ANE.0000000000001930
Critical Care and Resuscitation: Brief Report

Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways. For these reasons, the Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center created an Anesthesiology Perioperative Care Service that provides comprehensive care to surgical patients from their preoperative period through the continuum of their hospital course and postdischarge follow-up. In this brief report, we describe the development, implementation, and preliminary outcomes of the service.

Published ahead of print June 16, 2017.

From the *Department of Anesthesiology, Pain Management & Perioperative Medicine, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Anesthesiology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; §Department of Orthopaedic Surgery, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee; #Department of Urology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; and **Department of Surgery, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee.

Accepted for publication December 30, 2016.

Published ahead of print June 16, 2017.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article. We used REDCap, a secure online database, supported in part by the National Institutes of Health TR000445.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Bret D. Alvis, MD, Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Ave South, MAB Suite 526, Nashville, TN 37212. Address e-mail to bret.d.alvis@vanderbilt.edu.

© 2017 International Anesthesia Research Society
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