Perioperative medicine emerges as a system wide strategy for better surgery outcomes

Perioperative medicine is emerging as a transformative, comprehensive, system-wide approach to patient care before, during, and after surgery – that reduces complication rates and hospital days, provides better health outcomes, and improves health system performance, according to a special article in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA).

Perioperative medicine describes a more organized and coordinated process for surgery, with multiple specialties working together to increase efficiency and improve patient safety. It envisions surgical care as a collaborative approach among surgeons, anesthesiologists, primary care physicians, nurses, and other specialists – all working together to manage complex patients at every step of the surgical journey."

Maxime Cannesson, MD, Chair, Center for Perioperative Medicine, American Society of Anesthesiologists

Cannesson is also a member of the writing workgroup.

Perioperative medicine entails surgical review and risk assessment, steps to optimize the patient's condition before surgery, comprehensive care in the operating room and during recovery, and providing ongoing patient care and follow-up.

Emphasizing teamwork, leadership, communication, and well-being, the perioperative medicine approach prioritizes quality of life, function, and experience – not just technical success.

"For patients and families, this translates into earlier, more meaningful preparation for surgery, fewer cancellations and delays, clearer communication among the healthcare team, and reduced complications – all of which directly affect recovery, costs, and peace of mind," said Thomas R. Vetter, M.D., corresponding author to the journal article and member of ASA's Center for Perioperative Medicine. "By preparing patients to be healthier before surgery, perioperative medicine provides an opportunity to improve long-term health."

The special article provides updates and consensus on the field from the 2024 and 2025 perioperative medicine stakeholder summits hosted by the ASA's Center for Perioperative Medicine (CPMed). The article incorporates real‑world perspectives from a range of professionals involved in surgical care, both from the national and international medical communities.

The special article situates perioperative medicine within the ongoing pressures of the healthcare system, including workforce shortages, staff burnout, and accountability for patient outcomes. It highlights how perioperative medicine is a practical solution to emerging episode-based and value-based payment models, such as the Centers for Medicare & Medicaid Services' Transforming Episode Accountability Model (TEAM).

Assessing the economic impact of perioperative medicine interventions will be a critical step in implementing value-based surgical care. "Health systems will benefit from improvement in care processes and better patient‑reported outcomes," said Dr. Cannesson. "These improvements make perioperative medicine a system‑level investment: an institutional function requiring governance, metrics, and financial alignment."

Building on their discussions, the CPMed perioperative medicine summit participants developed a "forward-looking roadmap" to define the future of perioperative care over the coming decade. Successful efforts will require alignment of four integrated pillars: clinical care, education, research, and leadership. "Progress in one area alone won't be enough," said Dr. Cannesson. "Lasting improvement will require simultaneous development of workforce training, standardized outcomes research, and effective leadership structures to support multidisciplinary teams."