The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs

Patient Engagement Drives the Positive Impact of Prehabilitation

“…Evaluation of our own program supported the basis of this theory, and comparable results have been demonstrated upon assessment of similar programs 5,[19][20][21]. To our knowledge, our study is the first to support the idea that, in addition to a formal program, patient-dependent factors play a significant role in the cost-savings impact of prehabilitation.Data from this study has informed continuous MSHOP process improvement, identified opportunities to improve patient education, and provided cost-effectiveness analysis to support implementation of MSHOP outside of our institution.…”

Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery

“…All participants received standardized perioperative care according to the ERAS Society Guideline protocol, 4,5 which is based on a clinical program implemented at our institution since 2008. The main elements include a minimally invasive surgical approach when feasible, epidural analgesia, limited use and duration of drains, minimized blood loss and perioperative fluid administration, avoidance of preoperative over-night fasting, early oral nutrition, respiratory physiotherapy, and early mobilization.…”

“…Through multimodal approaches, including structured exercise, nutritional counseling, and patient empowerment, prehabilitation programs can improve the patient's preoperative functional status, reduce postoperative complications and length of stay, and lower costs of care. [1][2][3][4][5] In this issue of JAMA Surgery, Minnella and coauthors 6 report their findings from a randomized clinical trial analyzing 51 patients undergoing esophagogastric cancer resection. Prehabilitation was associated with improved preoperative and postoperative functional capacity.…”

Statewide Prehabilitation Program and Episode Payment in Medicare Beneficiaries

“…Per study protocol, only Medicare beneficiaries were included in the experimental group, although the program was offered to all patients regardless of insurance status. Once enrolled in the program, each patient received individualized instruction on physical exercise, nutrition, smoking cessation, incentive spirometry, and stress reduction techniques, as described previously 11 (program details in eDocument 1). Patients received a pedometer, incentive spirometer, and training education materials at enrollment.…”