The Perioperative Surgical Home: Improving the Value and Quality of Care in Total Joint Replacement

Curr Rev Musculoskelet Med. 2017 Sep;10(3):365-369. doi: 10.1007/s12178-017-9418-3.


Purpose of review: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH.

Recent findings: The PSH model guides the patient throughout the pre and perioperative process and into the postoperative phase. It has been shown in multiple studies to decrease length of stay, improve functional outcomes, allow more home discharges, and lower costs. There is no increase in complications or readmission rates. The PSH pathway is a safe and effective method of providing value-based care to patients undergoing hip and knee arthroplasty.

Keywords: Arthroplasty; Bundled payments, readmission; Outcomes; Perioperative surgical home; Value-based care.

Publication types

  • Review