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The Surgical Solution Shop

By Sonya Pease, MD, Chief Medical Officer, Anesthesiology

Our primary role as physicians and advanced practice clinicians (APCs) is to take great care of patients. In a healthcare environment so focused on costs as we shift to value-based care where reimbursement is tied to the quality and efficiency of the care delivered, it’s easy to feel overwhelmed or cynical by the regulatory reporting requirements. With clinician burnout on the rise, how do we get back to taking great care of our patients?

The answer may be to approach patient care through the same “solution shop” business model used in other industries. This wouldn’t be the first time the healthcare industry has borrowed from other industries to continually reinvent itself. Think about how we pulled critical event analysis from the world of aviation to create the Anesthesia Patient Safety Foundation (APSF), which has been crucial to reducing errors that harm patients. Consider how we adapted LEAN Six Sigma, a performance improvement strategy that rose up in the early 1990’s auto industry, and we applied LEAN methodologies to the healthcare industry to better standardize processes to improve patient flow and decrease waste. Simply put: more often than not, an error is an error that can be addressed at a system level, just as a process is still a process regardless of the setting.

The Surgical Solution Shop approaches surgical and procedural-based care in a way that incorporates value-added processes, like LEAN initiatives within a coherent Solution Shop structure that assembles a highly-trained team of experts to address complex problems surrounding perioperative care to drive better outcomes as an endpoint. Think about it as a multi-disciplinary team working together to collaborate on a patient with a complex disease process such as cancer, which requires coordinating multiple specialists along the path to a cure, but applied at the hospital system level regarding surgical services.

The Perioperative Surgical Home (PSH) is an example of a Surgical Solution Shop, and the perioperative efficiencies achieved by standardizing clinical care pathways allows us to better match resources to non-standard care as appropriate. Care coordination is achieved when clinical experts work collaboratively across specialties in a team-based approach to provide the best outcome for the patient. In the words of Atul Gawande, MD, MPH, is a surgeon, writer and public health leader, “Teams of clinicians deliver far better results than autonomous specialists, each doing their own thing.”

In the PSH model, the anesthesiologist is the perioperative intensivist who facilitates collaboration with multiple specialties on care paths and oversees a robust perioperative pre-admit clinic that manages patients based on comorbidities or by the planned surgical procedure. Issues such as anemia and diabetes can be identified, treated and optimized prior to surgery. Patients are educated about the procedure-specific goals of care that can enhance their recovery. These interventions decrease perioperative complications and enable patients to be discharged quicker and with fewer readmissions.

With TeamHealth’s anesthesiology services, we’re confident that the only people happier than your surgeons will be your patients. Learn more about how we are pioneering care management inside and outside the operating room by visiting our website, calling 800.818.1498 or email us at