My mentors in surgery never allowed us to view surgery as solely the surgical event.
Truly knowing the patient, preparing the patient mentally and physically, and working with other providers to ensure excellent post-operative care were all inherent parts of the job — not “extras.”
The truth is that the structure of the medical system has made this approach increasingly difficult to carry out. Ironically, though, many of our most pressing health issues demand this kind of approach. So I was inspired recently to hear about a new program using just this kind of holistic approach -- achieving tremendous success, in a major hospital system.
As we know, recovering from surgery can be slow and complex, even in the best of times. In the midst of an opioid epidemic, however, there are even more reasons that surgical recovery can touch off opioid addiction. On the face of it, it doesn't sound like a problem you could do much about -- but Geisinger Health System, a major Pennsylvania-based hospital system, decided they could do something about it.
Rather than trying to address opioid problems directly and after-the-fact, Geisinger's program uses a holistic model to prevent issues before they start.
As Fierce Healthcare explains, “Pennsylvania-based Geisinger Health System is launching a program to "redesign" the surgical experience aimed at improving the healing process following surgery while ultimately tackling one of the major sources of opioid addiction: postsurgical care. Officials said their Proven Recovery program rethinks the surgical experience by pushing patients to be healthier before surgery, which leads to fewer complications.”
Since June 2017, when the program began, opioid usage across the system has dropped 18%. Perhaps even more astounding, hospital stays for neurosurgery and colon surgery went down by a full 50%.
The program focused on pre-surgery and post-surgery approaches, like making it easy for patients to achieve proper nutrition, a focus on non-opioid and targeted pain approaches, as well as focusing on mobility after surgery.
In many ways, this program isn’t cutting-edge medicine. It’s appropriate pre- and post-surgical care. “Appropriate” care is always holistic in these ways — and at other points in the history of healthcare, this kind of approach wouldn’t be out of the ordinary.
That said, the frustrating truth is that this kind of holistic program is so rare that the results Geisinger is getting are truly exceptional. The way the medical system is structured, a program like this — which is preventative, collaborative, and holistic — simply isn’t easy to create or get support for.
We hope that models like this pave the way for more programs that tackle challenging problems in smart, holistic, collaborative ways. And we will continue to make sure that courageous healthcare providers like these have the tools they need to overcome silos and work in medical collaboration, together.