What is perioperative medicine?
Perioperative medicine emphasises the importance of an integrated, planned, and personalised approach to patient care before, during, and after any surgical procedure involving anaesthesia.
The goal is to improve the patient experience, reduce postoperative complications, reduce inpatient hospital days and reduce early re-admissions following surgery. We call this a "perioperative care model".
What are the advantages of a perioperative care model?
Australia and New Zealand are two of the safest places in the world to have an operation under anaesthesia, and the chances of dying due to complications during surgery are extremely low (1:100,000 cases). But complications arising after an operation are the third leading cause of death in the developed world.
Adopting a perioperative care model can improve the care of all patients. But the greatest benefits will be to vulnerable patients such as the very old; the very young; and those with underlying health conditions.
How does it work?
An effective perioperative care model will include a series of activities such as:
- Evaluating patients before surgery to identify any risks.
- Producing a personalised plan around preparing for surgery.
- Monitoring patients closely throughout the operation.
- Continuing to monitor the patient's progress with recovery after they're discharged.
- Clearly communicating with the patient and their primary carer or referrer, to ensure that surgical outcomes align with their expectations and wishes.
- Co-ordinating healthcare personnel and systems.
- Shared decision making.
Who is involved?
This approach requires close, continuous communication, collaboration, and co-ordination between healthcare practitioners at every stage of a patient's journey, from their pre-procedure preparation to their post-operative rehabilitation. In particular:
- Specialist doctors (such as anaesthetists, surgeons, and physicians).
- The patient's general practitioner (GP).
- Allied health practitioners and providers.
What does a perioperative specialist do?
Perioperative practitioners help patients navigate the healthcare system and co-ordinate their care by different clinicians and sub-specialties through shared decision making. A good perioperative specialist aims to:
- Improve the patient's experience.
- Reduce postoperative complications.
- Reduce inpatient hospital days.
- Reduce early re-admissions following surgery.