Document Type

Master's Culminating Experience

Publication Date



Perioperative Surgical Homes (PSH) are evolving patient-centered medical home models that coordinate stream-lined care among all providers in the care process. The PSH model can serve as a solution to improve quality assurance, patient satisfaction, and reduce errors that lead to poor outcomes, many of which are preventable and can lead to higher costs. This model has many benefits, but it can be a challenge to execute in a hospital system. TriHealth chose to adopt a PSH model, the TriHealth Surgical Optimization Center (TSOC) in March 2017. It implemented a pilot program for its colorectal patients. Metrics of primary interest to TriHealth included: the rate of late surgery starts for the first case of the day, the delay reason accompanying it, and the time of delay measured in minutes from the scheduled start time.
It was hypothesized that the TSOC program would decrease the number of surgeries with delayed starts, as well as the time to delay. Surprisingly, analysis showed no change in the frequency of late start surgeries between the two cohorts, pre-TSOC and post-TSOC. However, there was a significant reduction in time delay for late start surgeries, from 17.8 minutes pre-TSOC to 10.0 minutes of delay post-TSOC. Additionally, the number of first cases delayed was largely related to surgeon delay, which increased to 37% upon TSOC implementation. This study gave insight to surgical protocol and patient care issues that still exist within the TSOC program, and subsequently the downstream effect on the health of the patient population served.

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