• U Nilsson, R Gruen, and P S Myles.
• Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Peri-operative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
• Anaesthesia. 2020 Jan 1; 75 Suppl 1: e158-e164.

AbstractAn ageing population and rising healthcare costs are challenging cost-efficient hospital systems wanting to adapt, employing novel organisational structures designed to merge diverse skill sets. This needs not only physician and nursing leadership but also new models of care. Anaesthetists have expanded their role into the broader multidisciplinary field of peri-operative medicine, emphasising collaboration and safety in health teams. A greater focus on patient-centred care and shared decision making, along with validated metrics to quantify quality improvement activities, have emphasised the importance of comfort, patient satisfaction and quality of life after surgery. Shared decision-making is more likely to be manifest in a flat hierarchy in which each member of the team brings their own experience and skills to optimise patient care. Successful surgery is best achieved by a coordinated, multidisciplinary team, embedded in a culture of collaboration and safety.© 2020 Association of Anaesthetists.

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