Clinician perspectives on the perioperative roles and responsibilities of anesthesia, surgery, and primary care.

Anesthesia Care transitions Geriatric surgery Multidisciplinary care Perioperative care Preoperative assessment Primary care Surgery

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
01 Sep 2024
Historique:
received: 17 05 2024
revised: 07 08 2024
accepted: 30 08 2024
medline: 9 9 2024
pubmed: 9 9 2024
entrez: 8 9 2024
Statut: aheadofprint

Résumé

Although high-risk older patients benefit from a multidisciplinary approach to perioperative care, the specific roles and responsibilities of the clinicians involved have yet to be adequately characterized. Qualitative analysis of semi-structured interviews with four anesthesia preoperative clinic providers, seven surgeons, and nine primary care providers in northern New England. The analysis revealed both distinct and overlapping roles and responsibilities. Anesthesia providers were described as a "safety net" and surgeons as "captain of the ship", in charge of getting "all the ducks in a row" to avoid surgery delays and cancellations. Primary care providers saw themselves as the "quarterback", ensuring care continuity and consideration of patient psychosocial factors. While all have a shared responsibility for facilitating patient-centered decision-making and a safe perioperative course, each discipline has different areas of focus and expertise. Role clarification can help optimize the distribution of responsibilities and enhance perioperative communication and collaboration.

Sections du résumé

BACKGROUND BACKGROUND
Although high-risk older patients benefit from a multidisciplinary approach to perioperative care, the specific roles and responsibilities of the clinicians involved have yet to be adequately characterized.
METHODS METHODS
Qualitative analysis of semi-structured interviews with four anesthesia preoperative clinic providers, seven surgeons, and nine primary care providers in northern New England.
RESULTS RESULTS
The analysis revealed both distinct and overlapping roles and responsibilities. Anesthesia providers were described as a "safety net" and surgeons as "captain of the ship", in charge of getting "all the ducks in a row" to avoid surgery delays and cancellations. Primary care providers saw themselves as the "quarterback", ensuring care continuity and consideration of patient psychosocial factors.
CONCLUSIONS CONCLUSIONS
While all have a shared responsibility for facilitating patient-centered decision-making and a safe perioperative course, each discipline has different areas of focus and expertise. Role clarification can help optimize the distribution of responsibilities and enhance perioperative communication and collaboration.

Identifiants

pubmed: 39245593
pii: S0002-9610(24)00500-2
doi: 10.1016/j.amjsurg.2024.115948
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

115948

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Ron's work on this research is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award T32HP32520. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. Dr. Stacie Deiner is the LeRoy Garth Professor of Anesthesiology and is on the Board of Directors for the American Board of Anesthesiology, the views expressed in this manuscript are the authors and do not represent the official views of, nor an endorsement, by the American Board of Anesthesiology.

Auteurs

Donna Ron (D)

Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA; Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA. Electronic address: Donna.Ron@hitchcock.org.

Madison M Ballacchino (MM)

Jacobs School of Medicine and Biomedical Sciences, 955 Main St, Buffalo, NY, 14203, USA. Electronic address: mmballac@buffalo.edu.

Alexandra Briggs (A)

Department of Surgery, Dartmouth Health and Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA. Electronic address: Alexandra.Briggs@hitchcock.org.

Stacie G Deiner (SG)

Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA. Electronic address: Stacie.G.Deiner@hitchcock.org.

Classifications MeSH