As healthcare becomes increasingly value-based, surgical outcomes are more important than ever, leading many providers to assess patients’ fitness for elective procedures.
Increasingly, providers make an effort to learn more about patients’ health before operations such as hip and knee replacements, according to The Wall Street Journal, looking for evidence of dangers of infection and other complications. Patients with chronic conditions or lifestyles that put them at higher risk may be directed to “pre-habilitation” programs to increase the odds that their procedures go off without a hitch. These initiatives can involve medical treatments or simply improved diet and exercise, according to the article.
This approach builds on strategies surgeons have employed for years, including advising patients to quit smoking or get in better shape ahead of a procedure, but the range of risks they focus on has broadened considerably to encompass everything from sleep disorders to mental illness, according to the article.
“In health care, we often bring patients into surgery without fully addressing their chronic medical conditions,” Solomon Aronson, M.D., executive vice chair in the anesthesiology department at Duke University School of Medicine in Durham, North Carolina, told the WSJ, and when patients are healthier pre-surgery, “we can significantly diminish the risk of complications.”
For example, Duke Health’s “Poet” (Peri-Operative Enhancement Team) program has focused its efforts on patients with anemia, malnourishment, poor tolerance for exercise, complex pain disorders and diabetes. The fixes the provider offers range from pre-operative iron infusions for anemic patients to a protein shake regimen for older, malnourished patients. In the cases of patients who need such fixes as weight loss or blood sugar control, the Duke team employs longer-term regimens as well.