A Better Kind of Surgical Care

Chris Steel MD, Jeff Angel MD

Batesville, Ark - White River Medical Center is one of 40 hospitals in the United States, and the only community hospital voluntarily participating in a pilot project with the Centers for Medicare and Medicaid Services called The Perioperative Surgical Home (PSH).  The program was developed through the collaboration of the American Society of Anesthesiologists, the Premiere Alliance and hospitals throughout the country. Rather than describing a place, the perioperative surgical home describes an innovative approach to surgical care that improves care coordinator, patient education, and hospital processes to improve health and reduce costs.

Under the leadership of co-directors, Chris Steel, M.D. and Jeff Angel, M.D., the WRMC PSH is achieving results and sharing best practices with other hospitals in the pilot group. Additionally, Matthew Hazel serves as the business manager of the program, and Gloria Vaughn, Christina Howard, Jacquelyn Wright and Lisa Crumley work with patients who are a part of the program.  Administratively Gary Bebow, WRHS Chief Executive Officer;  Tammy Gavin, Chief Clinical Officer;  and Gary Paxson, Chief  Quality Officer provide leadership and administrative support.  As an organization, Approve Home Medical Services, Inc., are training Health Coaches on Patient Education.

 At WRMC, the project began with total knee replacement surgeries with Orthopaedic Surgeons, J.D. Allen, M.D., Jeff Angel, M.D. and Dylan Carpenter, M. D. who enthusiastically supported the project.

“This project is a perfect fit for patients choosing total joint replacement,” said Dr. Angel. “We began to see immediate results with the program. Patients experienced better pain control and a shorter hospital stay which improved patient satisfaction. Clinically, the pre-operative education and preparation result in fewer complication and unintended hospital readmissions.”  

The PSH is built around the concept that patients who accept an active role will experience a better result, and the standardization of clinical processes will improve efficiency and reduce cost.  In the hospital,  the PSH Team examines every part of the surgical process to develop protocols that standardize processes using evidence based best practices proven to improve patient care. 

Physicians discuss with patients their readiness for surgery and offer recommendations for how patients can better prepare with the goal of a shorter recovery and faster return to normal activities. By using a multidisciplinary approach to care, patients have one resource for all the information related to their hospitalization. Improving communication across the continuum of care enables the physician and care team to utilize other resources that a patient may need.  For example; diabetic patients may benefit from a nutritional consultation prior to surgery to learn how changes to their diet can help stabilize blood sugar after surgery.

“The PSH brings together every person involved in our patients’ care including the patient and their support system, said Dr. Steel. “We look at their experience as one event, rather than a series of events that result a joint replacement or other procedure.  It is exciting to be a part of a project that is making a difference for our patients.   We are eager to use what we learned to improve care throughout our organization and to share with other hospitals that are a part of this important project.”