Perioperative management

Abstract

Perioperative care, put simply, is the medical care provided to prepare a patient for surgery and to hasten recovery thereafter. Perioperative patient care is as integral to the outcome of the patient as the operation itself. In many cases, quality care may be more important to the achievement of a good outcome than the operation (e.g., when a major complication occurs after minor surgery or when a patient with complex medical problems must be managed for a straightforward operation). The simplicity of these statements belies the complexity of the issues because numerous fundamental questions must be addressed before considering the specifics involved. What is the duration of the perioperative period, and what marks its beginning and end? What constitutes a good outcome, and from the perspective of whom-The physician, the patient, or some external agency? What constitutes quality care, how can quality be measured, and are there characteristics of high-quality providers or units that are worthy of emulation? What standards of evidence should be applied for the evaluation of efficacy and effectiveness, and what are their flaws? Even the question of who should provide perioperative care is debated, especially for the hospitalized and seriously ill patient. © 2008 Springer New York.