• Michele Homsy, Julius Dale-Gandar, SchwarzStephan K WSKWDepartment of Anesthesia, St. Paul's Hospital/Providence Health Care, Vancouver, BC, Canada.Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada., Alana M Flexman, and Su-Yin MacDonell.
• Department of Anesthesia, St. Paul's Hospital/Providence Health Care, Vancouver, BC, Canada.
• Can J Anaesth. 2024 Dec 1; 71 (12): 165316631653-1663.

AbstractApproximately 320 million surgeries occur annually worldwide, increasingly performed on an ageing, comorbid population in whom postoperative complications contribute significantly to mortality. While anesthesiologists have led advances in perioperative care, the optimal structure of the provision of postoperative care has lacked discourse. In this article, we describe the implementation, structure, role, and benefits of an Anesthesiology Perioperative Outreach Service (APOS) at a Canadian tertiary hospital, providing proactive daily review and management of high-risk surgical patients. The APOS involves routine reviews and care on surgical wards, emphasizing collaboration among anesthesiology, internal medicine, surgery, and geriatric medicine teams, with a specific screening pathway to identify patients experiencing myocardial injury after noncardiac surgery. We discuss case vignettes to illustrate common examples of how the APOS enabled early detection and treatment escalation for deteriorating patients and provide a focused narrative literature review. The anesthesiology-led perioperative outreach model described herein could provide an implementable framework for institutions seeking to enhance their quality of postoperative care-particularly among complex, comorbid patients at risk of postoperative morbidity.© 2024. Canadian Anesthesiologists' Society.

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