Perioperative medicine

Perioperative medicine is a key focus for the college, and is one of the pillars of our 2018-2022 strategic plan.


What is perioperative medicine?


Perioperative medicine (POM) is the multidisciplinary, integrated care of patients from the moment surgery is contemplated through to recovery. It involves:

 

  • Preoperative evaluation.

  • Risk assessment and preparation.

  • Intraoperative care.

  • Postoperative care (including monitoring, rehabilitation and post-discharge).

  • Communication and handover to primary care or referrer.

  • Coordination of personnel and systems.

  • Shared decision making.


Perioperative medicine aims to facilitate effective communication with the patient and their family to ensure that surgical outcomes align with their expectations and wishes.
 

The perioperative specialist will help patients navigate the healthcare system and co-ordinate their care by different clinicians and sub-specialties through shared decision making. The goal is to improve the patient experience, reduce postoperative complications, reduce inpatient hospital days and reduce early re-admissions following surgery. 


ANZCA Council approved a vision for the perioperative medicine program in February 2018. This vision and the ANZCA Strategic Plan 2018-2022 will guide and inform our work. 

You can find a good summary of "Where we have come from and where we are heading" in the March 2019 ANZCA Bulletin.

 

Governance of perioperative medicine projects


We have formed a Perioperative Medicine Steering Committee that reports to ANZCA Council. The steering committee comprises representatives from ANZCA and other colleges reflecting the diverse nature of the perioperative space. It has established the following cross-college working groups, which will report their findings to the committee by mid-2019.
 

Perioperative Medicine Education Group (PMEG)

The PMEG will make recommendations on the type of education offerings that could be developed by ANZCA. As part of that work, the PMEG will recommend a definition of a perioperative specialist, develop a graduate outcome statement (that is, what a perioperative specialist will look like) and a curriculum framework, and identify potential learning opportunities. The group will align any education work with the International Board of Perioperative Medicine (IBPOM) syllabus.

Members of the PMEG include representatives from ANZCA, FPM, the Royal Australasian College of Surgeons, the Royal Australasian College of Physicians and the College of Intensive Care Medicine. The group is chaired by ANZCA councillor, Dr Sean McManus.
 

Perioperative Care Working Group (PCWG) 

The PCWG will recommend definitions of perioperative medicine and a perioperative medicine service. It will recommend the scope of a perioperative medicine service, identify the types of services currently available in Australia and New Zealand, and propose quality indicators for future services.

Members of the PCWG include representatives from ANZCA, the Perioperative Medicine Special Interest Group, the Australian College of Rural and Remote Medicine, the College of Intensive Care Medicine, the Royal Australasian College of Physicians, the Australian Society of Anaesthetists and the Royal Australasian College of Surgeons. The group is chaired by Dr Jeremy Fernando, chair of the Perioperative Medicine Special Interest Group.


We are also working closely with the Perioperative Medicine Special Interest Group, which is publishing regular e-newsletter updates, to ensure that we leverage existing perioperative medicine relationships, knowledge and skills. 
 

What we've achieved so far

 

 

What’s next?
 

In 2019, the perioperative medicine program will focus on:
 

  • Developing a curriculum framework that will guide the development of ANZCA perioperative medicine education offerings. This will include a graduate outcome statement that defines what a graduate of any perioperative medicine education offering will be able to do.  

  • Considering perioperative models of care.

  • Using multi-speciality working groups to develops the definitions of perioperative medicine, perioperative medicine specialist and perioperative service to inform all future work.

  • Enhancing the perioperative medicine literature review. 

  • Engaging the ANZCA Research Foundation Committee and researchers to create interest in, and generate perioperative medicine research activity. 


By the end of 2019, we anticipate that we will be well-placed to develop an evidence-based and profession-supported education offering that will, over time, enhance patient safety through consistent perioperative care practices across Australia and New Zealand.

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