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Peri-Operative Surgical Home (POSH): Welcome!

Welcome to the Peri-Operative Surgical Home (POSH) Website!

Peri-Operative Surgical Home (POSH) is an innovative, comprehensive, systematic, multidisciplinary, collaborative program for surgical care at Phoenix Indian Medical Center (PIMC) led by the General Surgery department.  Our mission is to provide outstanding patient-centered surgical care throughout the surgical continuum based on best practices and evidence designed specifically for PIMC patients. Our goals are to improve patient experience and outcome, to provide excellent patient care based on current best practices, to recognize and manage complications early, to control costs, and to promote continuity throughout the pre-operative, intra-operative, and post-operative phases and across inpatient and outpatient venues. 


The Perioperative Surgical Home (PSH) is a new and emerging concept in health care delivery. A small number of other programs exist around the world. These programs are led by anesthesiologists and/or are structured around a single operation type. POSH has synthesized ideas from these anesthesia-led PSH programs, the medical home model, fast track and recovery pathways, care coordination research, and experience caring for our patients into a unique, formal program at PIMC. Very few surgeon-led surgical homes currently exist. Surgeons are uniquely positioned to develop such a program as surgery is the only discipline to see the patients through the entire process, from preoperative referral to post-discharge clinic follow-up. POSH addresses all types of disease processes and operations, and includes all departments who have contact with the patient or are involved in the peri-operative process.  PIMC Departments contributing to POSH include Anesthesia, Behavioral Health, Case Management, Endocrinology, Engineering, Family Medicine, Inpatient Hospitalist Medicine, Integrated Surgical Services (including staff from Same Day Surgery, Operating Room, Post-Operative Care Unit, and Central Supply), Medical Informatics, Medical Library, Nursing, Nutrition, Oncology, Pharmacy, Physical Therapy, Primary Care, Respiratory Therapy, Safety, and Surgery.


The POSH Program at PIMC is also distinguished by our many unique, signature initiatives including:

POSH U, our comprehensive education program for all students, residents, and clinicians who work with surgical patients

We Move!, an Early Mobilization program for all admitted patients at PIMC which is designed to get our patients moving and back to function as soon as possible. We Move! is one of our Clinical Guidelines and Pathways, all of which support our commitment to providing standardized, high quality patient care that is tailored for our institution and individual patients. Our Pathways are based on current evidence and best practices and are linked to these sources in our Reference Library.

POSH FORWARD, our guide to initiating and growing POSH at your institution.

This website is designed to facilitate our goals of high quality, patient-centered care, and transparency, and to support our community culture of excellence and life-long learning. Each page contains key information, presentations, guidelines, and references for surgical patients and care at PIMC.


POSH welcomes comments and suggestions from all members of the PIMC Community. If you have any, please use the form on the "Feedback" tab or email Dr. Anathea Powell at


If you are interested in starting a POSH program at your institution, please start with our POSH FORWARD page. You may also contact Dr. Powell, Founder & Director of POSH, at the email address above. We love to talk about POSH and how it can help your patients, staff, and institution!


 Thank you for visiting the POSH Website!


Breaking POSH News

The POSH IRB-approved outcomes project has been completed and accepted for publication. The manuscript, "Early Results of a Surgeon-Led, Perioperative Surgical Home" will be published in the May 2017 edition of Journal of Surgical Research. You can find the manuscript early here (full text available until March 1, 2017).  The authors are Anathea Powell (surgery), Marie Thearle (our former endocrinologist and research support), Matt Cusick (surgery), Dorothy Sanderson (inpatient medicine), Holly Van Lew (pharmacy), Candace Lee (nursing), and Jennefer Kieran (surgery). 

POSH was a finalist in the 2015 HHS Innovates contest, AND POSH won the Employees Choice Award! Check all of the innovations out here

The most recent edition of the Op-Note is always available below. Previous editions are archived on the Op-Note page.

Description of Pages

POSH Overview:  general information about POSH, our mission, and our specific goals

Education Program: links to the individual elements of the POSH Education program

Clinical Programs:  POSH-designed clinical programs based on best practices and evidence designed specifically for PIMC

We Move!: information about this important project designed to get patients out of bed and back to function as soon as possible after admission and/or operation

EHR: a resource for EHR projects

Reference Library: links to the citations and abstracts for sources upon which our guidelines and pathways are based

Op-Notes: links to "Op-Notes," the POSH newsletter with all the latest information

POSH Team Pictures: we're having fun with POSH! Come see what we're doing.

Helpful Links: links to helpful Indian Health Service and PIMC websites

Feedback: a forum to tell us how we're doing

POSH FORWARD: a page devoted to helping other institutions learn about building and growing a POSH program