Comprehensive Preoperative Assessment and Global Optimization

Neil N Shah; Thomas R Vetter

doi:10.1016/j.anclin.2018.01.006

Comprehensive Preoperative Assessment and Global Optimization

Anesthesiol Clin. 2018 Jun;36(2):259-280. doi: 10.1016/j.anclin.2018.01.006.

Authors

Neil N Shah¹, Thomas R Vetter²

Affiliations

¹ Department of Medicine, Dell Medical School, The University of Texas at Austin, Health Discovery Building, 1701 Trinity Street, Austin, TX 78712-1875, USA.
² Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Health Discovery Building, Room 6.812, 1701 Trinity Street, Austin, TX 78712-1875, USA; Department of Population Health, Dell Medical School, The University of Texas at Austin, Health Discovery Building, Room 6.812, 1701 Trinity Street, Austin, TX 78712-1875, USA. Electronic address: thomas.vetter@austin.utexas.edu.

PMID: 29759287
DOI: 10.1016/j.anclin.2018.01.006

Abstract

To successfully deliver greater perioperative value-based care and to effectively contribute to sustained and meaningful perioperative population health management, the scope of existing preoperative management and its associated services and care provider skills must be expanded. New models of preoperative management are needed, which rely extensively on continuously evolving evidence-based best practice, as well as telemedicine and telehealth, including mobile technologies and connectivity. Along with conventional comorbidity optimization, prehabilitation can effectively promote enhanced postoperative recovery. This article focuses on the opportunities and mechanisms for delivering value-based, comprehensive preoperative assessment and global optimization of the surgical patient.

Keywords: Medical comorbidity; Prehabilitation; Preoperative assessment; Preoperative optimization; Telehealth; Telemedicine; Value-based health care.

Publication types

Review

MeSH terms

Comorbidity
Humans
Perioperative Care
Preoperative Care / methods*
Preoperative Care / standards
Quality of Health Care / standards
Risk Assessment