OR teams are accustomed to using checklists to keep patients safe during surgery. Could extending presurgical checklists to the physician’s office or clinic produce even better results? The new Strong for Surgery initiative in Washington State is introducing checklists into offices and clinics to help address issues like nutrition, glycemic…

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Last month, we wrote about the long history of unnecessary preoperative testing for healthy patients. This month, we’re happy to report that some leading medical societies are publicly calling for physicians and patients to rethink certain kinds of testing. The recommendations are part of the Choosing Wisely campaign, an effort…

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This month’s article on preop testing research had a familiar ring (page 20). Researchers at the University of Texas Medical Branch (UTMB) in Galveston have found much more testing is being done than seems to be needed. They’re documenting the patterns. Seems not much has changed. These new studies join…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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