Advancing the profession and avoiding the commoditization of anesthesiology

Wallace, Scott

doi:10.1007/s12630-022-02239-8

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…Postoperative care is currently a wide-open opportunity and a way to avoid commoditization of anesthesia, 21 just as wind and solar power initially was for coal miners. But it won’t stay open.…”

Section: A Safety Net—and a Fourth Branch Of Anesthesiamentioning

confidence: 99%

The Gathering Storm: The 2023 Rovenstine Lecture*

Sessler

2024

Anesthesiology

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Anesthesiologists are currently in demand and highly compensated. What appears to be a great success from our perspective is considered problematic from every other healthcare perspective. Consequently, there are powerful healthcare forces seeking to improve anesthesia access and reduce service cost. They will try to impose solutions that may radically change operative anesthesia. The Rovenstine lecture, delivered on World Anesthesia Day 2023, identified substantial challenges our specialty faces and discusses solutions that might be forced on us. It also presented opportunities in perioperative care.

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Section: A Safety Net—and a Fourth Branch Of Anesthesiamentioning

confidence: 99%

The Gathering Storm: The 2023 Rovenstine Lecture*

Sessler

2024

Anesthesiology

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“…First, anesthesiology commonly lacks validated, robust, consensus-driven indicators of success to demonstrate the role of anesthesiologists in creating value 1. Given the unique features of patients with neurological disease, further work is required to identify optimal perioperative outcomes for this cohort 30.…”

Section: Future Research and Challenges To Value-based Care In Periop...mentioning

confidence: 99%

“…First, anesthesiology commonly lacks validated, robust, consensus-driven indicators of success to demonstrate the role of anesthesiologists in creating value. 1 Given the unique features of patients with neurological disease, further work is required to identify optimal perioperative outcomes for this cohort. 30 Although surrogate metrics are often collected (eg, preoperative antibiotic administration), they typically focus on process compliance, are rarely patient-centered, and do not directly measure outcomes.…”

Section: Future Research and Challenges To Value-based Care In Periop...mentioning

confidence: 99%

“…Value-based care and quality improvement (QI) are key components of a successful health care system and represent a shift from traditional service-volume outcomes to a focus on patient-centered outcomes, satisfaction, and experience. Recently, Scott Wallace1 advocated for an urgent shift toward value-based care in anesthesiology to avoid commoditization of the specialty 1. Others have similarly cautioned that the anticipated shift from fee-for-service to risk-based alternative payment models means that it is essential that the contribution of anesthesiology to overall quality and cost efficiency measures must be recognized, otherwise the value of physician-led perioperative care to an organization will diminish 2.…”

mentioning

confidence: 99%

“…Recently, Scott Wallace 1 advocated for an urgent shift toward value-based care in anesthesiology to avoid commoditization of the specialty. 1 Others have similarly cautioned that the anticipated shift from fee-for-service to risk-based alternative payment models means that it is essential that the contribution of anesthesiology to overall quality and cost efficiency measures must be recognized, otherwise the value of physician-led perioperative care to an organization will diminish. 2 System transformation within perioperative neuroscience requires several steps: identification and measurement of disease-specific, standardized, and patient-centered outcomes; implementation of bundled care initiatives; and a focus on continuous QI for patients at risk of, or diagnosed with, neurological conditions.…”

mentioning

confidence: 99%

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Value-based Care and Quality Improvement in Perioperative Neuroscience

Luoma

Flexman

2022

Journal of Neurosurgical Anesthesiology

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Value-based care and quality improvement are related concepts used to measure and improve clinical care. Value-based care represents the relationship between the incremental gain in outcome for patients and cost efficiency. It is achieved by identifying outcomes that are important to patients, codesigning solutions using multidisciplinary teams, measuring both outcomes and costs to drive further improvements, and developing partnerships across the health system. Quality improvement is focused on process improvement and compliance with best practice, and often uses "Plan-Do-Study-Act" cycles to identify, test, and implement change. Validated, standardized core outcome sets for perioperative neuroscience are currently lacking, but neuroanesthesiologists can consider using traditional clinical indicators, patient-reported outcomes measures, and perioperative core outcome measures. Several examples of bundled care solutions have been successfully implemented in perioperative neuroscience to increase value; for example, enhanced recovery for spine surgery, delirium reduction pathways, and same-day discharge craniotomy. This review proposes potential individualand system-based solutions to address barriers to value-based care and quality improvement in perioperative neuroscience.

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