I have been in the healthcare arena for 32 years. My extensive career in nursing has provided exposure to multiple areas, such as pediatrics, internal medicine, hospice, and surgery. I have had the good fortune to work at New Hanover Regional Medical Center for over 20 years in Surgical Services. My position brought an extensive understanding for quality patient centered care and the necessary obligation to balance with financial responsibility. Since 2016 I have worked closely with anesthesia to develop and implement the Perioperative Surgical Home (PSH) and Enhanced Recovery Program (ERAS), a value based care model. The PSH/ERAS supports a best practice framework with solid economic rationale for cost containment. Since the successful rise of the PSH/ERAS program, I have expanded the program from one service line to seventeen fully standardized pathways which encompass over 50 procedures. Following the success of the PSH/ERAS program, my role has expanded to developing and implementing all Medicare best practice surgical programs, such as scaling inpatient to outpatient surgery, shifting surgeries to Ambulatory Surgery Centers (ASC), and expanding robotic surgery programs. I have written and copyrighted two implementation manuals with stepwise methodology. I have also been a contributing author on the PSH implementation manual for the ASA. I am considered a national subject matter expert on PSH and ERAS implementation. In the next phase of my career I look forward to mentoring other health organizations desiring to develop and launch value based care models such as PSH/ERAS .