Unfortunately, up to one third of health care expenditure is 'wasted' and not value driven. For patients having surgery in our hospitals, the factors that contribute to such waste include inadequate preoperative assessment, inadequate optimization, poor coordination of care and unnecessary laboratory testing, wide variation in heuristic practice patterns resulting in preventable postoperative complications and hospital readmission.

Postoperative complications are costly, reduce patients' long-term survival, and reduce the global access to surgery.

The Perioperative Surgical Home (PSH) harnesses new models of care and innovative approaches to perioperative care to achieve value driven outcomes and has been described as a "disruptive innovation" in contrast to a "sustaining innovation", which simply improves existing processes. This is achieved with a more proactive, patient-centred, evidence based, coordinated, team-based approach to perioperative care.