An 89-year-old female is in the O.R. for a hip fracture. The patient has coronary artery disease with a stent placed six months ago and severe chronic back pain. At the end of the case, the surgeon asks the physician anesthesiologist whether he should continue the Plavix and statin and seeks guidance for pain management. This scenario is commonplace, with the physician anesthesiologist providing comprehensive perioperative consultation, albeit on an ad hoc basis. In contrast, using a value-based care approach, the PSH teams codified each step of such a clinical scenario to provide timely and evidence-based care to obtain the most reliable outcomes for their patients.

Intuitively, “value” is easy to understand as a word, but difficult to identify in health care. In daily consumerism, each person makes purchasing decisions to get the best product for the...

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