Perioperative patient management

Modern perioperative care is complex and involves a large number of staff from multiple disciplines. Patient outcomes depend on well-designed processes, consistent clinical practice, and effective communication. Perioperative care should be a unified process of multiple coordinated steps. There should be a hospital-based multidisciplinary service to manage and plan this process. Early assessment of the patient's comorbidities is essential to plan patient preparation. Ideally, patients should be fully prepared before the day of surgery, and only admitted to hospital shortly before surgery. For many common clinical challenges, there is a range of accepted management regimes. Institutionally consistent clinical practice is necessary to optimise patient outcome. Postoperative management should be based on standardised observations and care protocols, prevention strategies targeted at common problems, and rapid response by high-level teams to early physiological signs of complications.