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 surgery are the third leading cause of death in the developed world. (Nepogodiev et al 2019)
Adopting a perioperative care model can improve the care of all patients and reduce the incidence of postoperative complications. But the greatest benefits will be to vulnerable patients such as the very old; the very young; and those with underlying health conditions.
This approach requires close, continuous communication, collaboration, and co-ordination between healthcare practitioners at every stage of a patient's surgical journey, from their pre-procedure preparation to their post-operative rehabilitation.
The perioperative care team
The perioperative care team includes everyone who may be involved in a patient’s perioperative journey. This may include doctors, nurses and other health professionals in hospitals or clinics, as well as family members or other carers.
The perioperative medicine team
Led by medically qualified specialists, the perioperative medicine team works collaboratively with the surgical team and the broader perioperative care team to support safe, effective and efficient care for patients for whom surgery is a potential treatment option. The team:
- Performs risk and needs assessment.
- Co-ordinates preoperative optimisation.
- Helps to prevent and respond to postoperative medical complications.
- Supports functional recovery.
The team complements the decision-making and care delivered by the surgical and other teams, in the preoperative, operative and postoperative phases of the patient's journey.
The patient’s perioperative journey can vary considerably in complexity. Members of the perioperative medicine team may include consultants in anaesthesia, pain medicine, internal medicine, geriatric medicine, rehabilitation medicine, general practice, other medical specialities, and intensive care.
The team also works collaboratively with primary care, nursing and allied health professionals along the perioperative journey to provide holistic care.
Perioperative medicine practitioners help patients navigate the healthcare system and co-ordinate their care through shared decision making. A skilled perioperative medicine practitioner aims to:
- Improve the patient's experience.
- Reduce postoperative complications.
- Reduce inpatient hospital days.
- Reduce early re-admissions following surgery.
Underpinning our perioperative care model is the Perioperative Care Framework that maps the patient’s journey from the time surgery is contemplated through to an optimal outcome. The perioperative care framework has been constructed to unpack each component of this journey in timeline format.