Forum Focus – Founding participant of ASA Perioperative Surgical Home Learning Collaborative 1.0 shares experiences on evolving model of care

Sonya Pease, M.D., second from left, with members of her TeamHealth PSH team.

Sonya Pease, MD, second from left, with members of her TeamHealth PSH team.

In November 2015, 44 leading health care organizations wrapped up a year and a half-long Learning Collaborative designed to evaluate the viability of the Perioperative Surgical Home (PSH) model of care. Developed by the American Society of Anesthesiologists (ASA), the PSH is a patient-centered, team-based practice model of coordinated care that guides patients through the entire surgical experience, from the decision to undergo surgery to discharge and beyond.

One of the 44 participants, TeamHealth, a multispecialty physician group based in Palm Beach Gardens, Florida, ended its run with the first Learning Collaborative determined to help expand the PSH model across its facilities nationwide.

TeamHealth Chief Medical Officer Sonya Pease, MD, talked about her group’s challenges and successes with their PSH:

What prompted you to incorporate a PSH in your institution? 

Our organization is a multispecialty physician group, so strategically the goals of improving integration across service lines aligned perfectly with the goals of coordinated care in the Perioperative Surgical Home. So for us it was a no brainer, an opportunity to get smarter faster with added resources and infrastructure. It was also a way of engaging our hospital C-suites and post-acute care partners in a joint effort by becoming a part of their organizations’ value stream as well. So being a part of this collaborative not only improved our internal integration efforts, it helped us integrate better with our health care organization partners.

What kind of reaction did you get from your group? From the C-suite? 

Most of our medical directors were very wary of the added work. Leadership is work and requires time and requires support, so we hired a full-time project manager and decompressed some clinical time so our leaders could be engaged. Our C-Suites have been very engaged and supportive. In fact, all of our innovation sites have a C-suite executive sponsor, and all of our sites have actively participated in the collaborative quarterly meetings.

How successful has your PSH been so far?

On a scale from 1-10, I’d say overall we’re about a 7. Some of our sites started at a 1, some of our sites started at a 7, so those struggling at the bottom learned quicker and had a lot of tools and resources to use. Those who started on the higher end of the bell curve still showed significant improvement in the overall standardization and process improvement steps, but probably didn’t show as much growth simply because they were already great performers.

What have you learned through the process?

I look at the PSH initiative as a portfolio of work, everything from leadership alignment, clinical standardization, to quality management and improvement. There are definitely some steps and processes that have to be in place to do the next foundational elements, so having been a part of this at multiple sites representing community hospitals, academic hospitals, for-profit, non-profit, unions and non-unions, has given us a huge portfolio of tactics and strategies to make this possible in any environment.

What are your next steps?

Continue to hardwire what we have learned and continue to build out our portfolio of implementation tools so we can make this model of care the standard across all of our practices nationwide.

How has the learning collaborative helped you in your PSH journey?

It has helped enormously by doing the hard work of circling the wagons, hiring an excellent conveyor and putting the resources and tools into our hands to actually get out there and make something happen. We’re all competitive, and when you see what other organizations are doing first-hand, it’s impossible to stand there and do nothing. Being a part of the collaborative has created a lot of momentum within our organization.

The above piece was reproduced in part from an article previously published in the February 2016 ASA Monitor.

Learning Collaborative 2.0 Applications Due March 15!

ASA has partnered with Premier, Inc., a leading health care improvement company, to launch the second iteration of the PSH Learning Collaborative, which will run from Apr. 1, 2016 to Mar. 31, 2018.

Please visit and click on “Learning Collaborative,” where you will find detailed information on the PSH, the goals of the Learning Collaborative, and a toolkit to help get you started on your own PSH model.

Last year, the American Hospital Association’s Physician Leadership Forum and the ASA partnered on a half-day complimentary program at the Health Forum/AHA Leadership Summit exploring two care models that ease transitions across the continuum of care: the perioperative surgical home and the Hospital at Home®. A report of the proceedings can be downloaded by clicking here.