Session to examine need for pediatric Perioperative Surgical Homes

The Pediatric Perioperative Surgical Home — Wishful Thinking or a Dream Come True?
Sunday, 4-5:30 p.m.
Upper 1A-B

Establishing Perioperative Surgical Homes (PSHs) under the direction of physician anesthesiologists has been discussed for a few years, but the focus has been on treating adults. A Sunday session will look at options to make sure children will not slip through the cracks by looking at the possibility of developing pediatric PSHs.

“Pediatric practice at different institutions is quite varied. In a multicenter study just completed on pectus repairs, we saw that the perioperative care differs, and we don’t know what is best,” said Sabine Kost-Byerly, M.D. “I think we will have to develop a service line that looks at the optimal care for these patients to make it safest and provide the best value.”

With that as an inspiration, Dr. Kost-Byerly developed “The Pediatric Perioperative Surgical Home — Wishful Thinking or a Dream Come True?” which will be presented from 4 to 5:30 p.m. today in Upper 1A-B. She will be joined by three speakers who have recently published papers about PSHs.

“While this has been a hot topic for a few years now, there was really not much information out there for pediatric patients,” said Dr. Kost-Byerly, an Associate Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins University. “I became interested in it and I thought this would be a good topic because if we want to go down this route of the Perioperative Surgical Home, it will affect pediatric patients as well.”


Zeev N. Kain, M.D., M.B.A.

Zeev N. Kain, M.D., M.B.A., Professor and Chair of the Department of Anesthesiology and Associate Dean for Clinical Operations at the University of California, Irvine, will present “Patient-Centered Care and Shared Decision Making.”

“He will discuss the components that are required for such a model, the barriers to a successful implementation and possible solutions,” Dr. Kost-Byerly said. “Barriers include failures in provider-patient communication and patient compliance issues. He also will look at the logistics of family-centered care in community hospitals versus a tertiary care center.”


Lynne R. Ferrari, M.D.

Lynne R. Ferrari, M.D., anesthesiologist and pediatrician at Boston Children’s Hospital, will present “System-Wide Integration and Team Collaboration.” She will look at the service lines and case types that would benefit from a pediatric-specific surgical home.

“How would a pediatric surgical home be integrated with the pediatric medical home after patients leave the hospital?” Dr. Kost-Byerly asked. “What kind of residencies and fellowship programs may be needed?”

Tom Vetter, M.D., M.P.H., Professor and Vice Chair of the Department of Anesthesiology at the University of Alabama at Birmingham, will present “Value-Based Patient Care and Patient Safety.” He will examine the financial needs in developing a pediatric PSH.

“Dr. Vetter will define the need and the metrics for a pediatric postoperative surgical home,” Dr. Kost-Byerly said. “He will ask financial questions regarding co-bundled payments where Medicare has a very small role versus an adult practice.

“He also will look at the training. Does somebody need to be an M.B.A. to manage this? How do you establish this? What kind of obstacles would you have? How do you develop it, looking at surgical lines you could develop?”

The session will include time for discussion, including questions from the audience.

“This is a big topic. I think this is where we need to go to improve care, and I think anesthesiologists are the ones who understand it and already interact with the patients throughout the perioperative care continuum, from the pre-op evaluation center to postoperative pain management,” Dr. Kost-Byerly said. “We interact with many providers and already are the ones looking out for the patient at so many stations in the course of their stay at the hospital.”

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