Best practice & research. Clinical anaesthesiology
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Best Pract Res Clin Anaesthesiol · Aug 2022
ReviewPerioperative leadership in the non-operating room and ambulatory setting.
To create a successful ambulatory care center, healthcare systems need management that can understand and improve key ambulatory success factors such as quality of clinical care, clinical competence, regulatory compliance, financial management, and customer service. Effective leadership is a vital skill that can improve all these factors. This manuscript discusses successful perioperative leadership styles in the ambulatory setting and provides a framework for proven strategies that have improved patient care.
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Leadership is an infinite and tremendously complex journey along with paradoxes that cannot be captured comprehensively. Over the past decades, key dimensions of leadership have caught the attention of practitioners in the field of management sciences. Yet, leadership education in healthcare is still limited. This personal perspective aims to summarize key aspects of leadership, ranging from managing people to managing systems and oneself.
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Best Pract Res Clin Anaesthesiol · Aug 2022
ReviewManaging bottlenecks in the perioperative setting: Optimizing patient care and reducing costs.
Bottlenecks limit the maximum output of a system and indicate operational congestion points in process management. Bottlenecks also affect perioperative care and include dimensions such as infrastructure, architectural design and limitations, inefficient equipment and material supply chains, communication-related limitations on the flow of information, and patient- or staff-related factors. Improvement of workflow is, therefore, becoming a priority in most healthcare settings. We provide an overview of bottleneck management in the perioperative setting and introduce dimensions, including aligned strategic decision-making, tactical planning, and operational adjustments.
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Best Pract Res Clin Anaesthesiol · Aug 2022
ReviewBuilding a well-balanced culture in the perioperative setting.
Healthcare institutions are currently under enormous financial, political and social pressure. Especially in the perioperative setting, various professional groups with differing agendas, dynamic teams, high-stress levels and diverging stakeholder interests are contributing to tension on a variety of levels. ⋯ However, culture is a key factor in the search for optimal patient outcomes, quality of care, protection and long-time retention of staff, as well as economic success. In this review, we discuss important aspects to consider in building a great perioperative workplace, discuss indispensable adaptations in times of crisis and touch on urgently needed further investigations to optimize the art of developing, protecting, and cultivating a well-balanced culture.
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Perioperative medicine is now a well-recognized albeit still evolving, interdisciplinary subspecialty, which encompasses a wide array of equally invested stakeholders and equally important contributors. The practice of perioperative medicine is fundamentally and optimally a collaborative effort, which aims to provide a comprehensive framework encompassing all aspects of the patient's surgical journey. Moving from a conceptual model of perioperative medicine to an operational perioperative medicine program and clinic requires a methodical management approach. This comprehensive management approach considers a variety of factors, such as defining the mission of a perioperative medicine program, expanding the role of the anesthesiologist and internal medicine hospitalist, recognizing the role of the advanced practice provider, stratifying perioperative management of surgical patients, developing and implementing a program, undertaking a clinical proof-of-concept pilot of a program, scaling up and building out a program, maximizing the electronic health record, leveraging telemedicine and virtual health, and providing adjunctive services.