An earlier blog discussed the potential for the Perioperative Surgical Home (PSH) model to disrupt the standards of anesthesia care. In a follow-up to that discussion, change agents in the anesthesiology community are now proposing a value-based strategy to address efficiency and patient satisfaction. In this strategy, a complex value analysis will align with the PSH model, allowing for a successful patient care episode. In-depth analyses of value across the patient journey, particularly within a collaborative approach, are essential to the next frontier of high-quality anesthesia care.
In discussing a value-based approach to anesthesia care, it is necessary to introduce the concept of a “value chain”. As described by PSH expert and surgeon Dr. Jimmy Chung at the American Society of Anesthesiologists’ INSIGHTS + INNOVATIONS 2017 Conference, the value chain is a means of quantifying a clinical pathway with respect to value. Essentially, from pre-surgery to post-operative recovery, each step on the value chain should add value in a meaningful and significant way. To evaluate value added, healthcare administrators can evaluate such measures as cost reduction, improved outcomes, decreased length of inpatient stay, fewer follow-up visits, and/or long-term population health cost offsets. Of such variables, clinical efficacy and cost offsets are the two that require the most attention, as each impact the quality of care the hospital provides as well as the resources the institution can allocate to support such care. According to experts in value-based care, if a step on the value chain is not additive, it ought to be eliminated. Pain management is often a crucial additive factor for value in the pe