Ten elements of safer surgery. The third in a series, this article focuses on presurgical evaluation.   Making sure patients have the appropriate preoperative preparation, including testing, is necessary not only for patients’ safe care but also for a smooth process on the day of surgery. Advocate Health Care, a…

Read More

What preoperative tests does your facility require for a healthy 40-year-old having a knee arthroscopy? What about a healthy 82-year-old having an elective procedure? Do these patients need testing at all? A good deal of testing is performed without clinical indications, studies have found. Researchers at the University of Texas…

Read More

Ten elements of safer surgery. Second in a series.   Much of the effort to ensure correct-site surgery focuses on preoperative verification. But scheduling is where it all begins. Capturing complete and accurate information when the case is booked is key to preventing errors down the line. Scheduling flaws are…

Read More

A column on managing the OR revenue cycle.   What are the rules for charging for preadmission testing and postop recovery? How should ORs handle charges for a patient who stays in the OR because a postanesthesia care bed is not available? In this column, Keith Siddel, JD, MBA, an…

Read More

Patient satisfaction has risen, and OR delays and cancellations are down after a Preop Call Center was developed to give patients more advanced notice of their surgery times. Previously, patients were told to call between 2 and 4 pm on the day before surgery, which gave them little time to…

Read More

A 65-year-old man with heart disease schedules a knee arthroscopy with his orthopedic surgeon. Thirty miles away, a note pops up to notify the hospital’s presurgical clinic of the impending surgery. A nurse practitioner pulls up the patient’s electronic health record (EHR), where she reviews the patient’s history. Comparing the…

Read More

Preop “nurse navigators” aided by an electronic tool are helping a Pennsylvania health system create a more standardized, user-friendly preoperative process for preparing patients for surgery. A cornerstone of the process is evidence-based guidelines for preop evaluation developed by a 50-person task force. “We wanted to optimize our approach so…

Read More

Four years ago, Duke Health’s Preop Screening Unit was facing challenges. The unit had a full schedule, some appointments were double-booked, and some patients had long wait times. There was no system for separating healthy patients from complex ones. Meanwhile, surgery centers were asking the unit to provide screening for…

Read More

The preoperative process is critical to safe care and a smooth OR process. Missing paperwork, incomplete assessments, and the need for last-minute consults can disrupt any surgical day. Is a preoperative clinic the answer? Each organization needs to weigh the cost against the potential benefits, such as fewer delays and…

Read More

When leaders at New Jersey Surgery Center (NJSC) saw an increase in postoperative hypertension and lengths of stay for some patients, they decided to look deeper. They learned that discharges were being delayed because more patients were receiving vasoactive drugs and needed prolonged surveillance, says Patricia O'Donnell, RN-BC, CPAN, CAPA,…

Read More