Anesthesiology Residency Curriculum and Implementation of a Perioperative Surgical Home Curriculum: A Survey Study

Abstract

Background The perioperative surgical home (PSH) is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management. Many studies to date have looked at the clinical implementation of varied PSH models with promising results discussed. There are no studies directly examining concrete plans for the various Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs to implement augmented PSH training into curricula. The aim of this survey study was to better assess current residency training in PSH. Methods An 18-question survey developed by a team of research personnel familiar with the PSH was sent to all ACGME accredited anesthesiology training programs in the United States. Responses were quantified, and construct and external validity of the survey tool examined. Results 41% of the programs responded. 89% (95% CI 78-96%) of programs reported moderate or better understanding of the PSH. 34% (21-47%) had incorporated additional PSH training in the previous three years, and 32% (with no significant correlation to the previous group) had plans to integrate more training in the next 3 years. Conclusions Overall, the surveyed program directors voiced understanding of the value of the PSH model in patient care but remained hesitant to incorporate training specific to PSH into the anesthesiology residency curricula. Background Perioperative medicine (POM) is faced with major challenges in the cost and quality of care as evidenced by high complication and readmission rates as well as financial incentives to perform surgeries 1 . Some approaches to address this problem have focused on further expanding the role of anesthesiologists in the perioperative period and focusing on evidence-based standardization of surgical pathways. This is exemplified by models like the perioperative surgical home (PSH) 2 and enhanced recovery after surgery (ERAS) 3 . The PSH is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management 4 and has been a focus of the American Society of Anesthesiologists (ASA) in recent years. This evolving paradigm for surgical care has been shown to reduce costs while minimizing complications associated with the perioperative timeline 5 .