This chapter discusses how defining the structure and procedures of an acute pain service (APS) is essential to its success. The regional anesthesiologist will lead the efforts, choosing specific peripheral nerve blocks and multimodal analgesic techniques in the preoperative block area and continuing care in the operating room and later in the postoperative area. The APS extends to the patient floors, where a pain management plan is established by the acute pain specialist and augmented by knowledgeable practitioners in this area. Measuring outcomes such as pain scores and functional status is important; such data should be collected and reported to keep the goals of the APS patient centered and to demonstrate value for the hospital. Finally, the goals of the APS should align with the clinical and financial goals of the hospital it serves.