Special Considerations for the Pediatric Perioperative Surgical Home: One Size Does Not Fit All

Eight years ago in the 44th Emery A. Rovenstine Memorial Lecture, Mark A. Warner, M.D. posed this provocative question in his address to ASA: “Who better than anesthesiologists?”¹  He also noted that there was an increasing demand for “providing care to children younger than 2 years of age in pediatric focused medical centers.” Since then, ASA has vigorously promoted the Perioperative Surgical Home (PSH), focusing on innovative, patient-centered and coordinated models of care. Two models of the PSH have been proposed and published based on a general hospital setting; however, the implementation of the PSH has not incorporated comparable pediatric models.^2,3  The development of these models should consider the specific issues related to the general pediatric population, including the significant numbers of children with special health care needs. There is little doubt that the perioperative management of the pediatric patient differs from general anesthesia practice. Collaborative...