North Colorado Medical Center creates pre-operative clinic
GREELEY, Colo. (July 23, 2010) — Preparing patients in advance of their surgery will ease anxiety and improve processes for surgeons and staff, say organizers of a new pre-operative clinic at North Colorado Medical Center.
Anesthesiologist Jim Birgenheier, MD, medical director Perioperative Services and Beverly Peratino, RN, M.S., nursing director of Perioperative Services worked collaboratively to gain administrative support for the Pre-Op Clinic. By better preparing the patient ahead of time, the patient having a positive experience on the day of surgery is greatly improved.
“We’re doing more complex surgeries on patients with more and more medical problems,” Birgenheier said. “It’s not enough time to develop a plan on the day of surgery. We need to assess the patients’ multiple conditions and optimize those conditions prior to the day of surgery.”
Vicky Schommer, RN, Manager Ambulatory Care Unit, said nursing staff worked for more than seven months to develop the pre-op program by visiting surgeon offices and working with multiple hospital departments to identify specific needs for the program.
“We put the patient in the center and then thought about all the hospital departments the patient touches,” Schommer said. “It helped bring our goal into focus: to make this the best possible patient experience.”
The operating room staff assists with an average of 30 surgeries during normal business hours at NCMC every day.
Birgenheier gave the example of a patient who comes in on the day of surgery and reveals that he or she has a pacemaker or defibrillator. Either of those devices would interfere with equipment used during surgery, so the surgical staff calls a cardiovascular technician to be present and address the device. This situation may delay or even cancel the procedure, which is bad for the patient, surgeon and staff.
Patients with multiple medical conditions require a special plan of care or certain assessments done prior to surgery. Knowing about those conditions early is crucial and will result in a better plan of care for the patient the day of surgery.
Education and pain management are also discussed during a pre-op visit. NCMC offers tailored education on total joint replacement, spine surgery and heart surgery. When education is offered in advance, the patient has time to think about the surgery and ask questions.
When it comes to pain management, the patient needs time to digest the information and make informed choices.
“I want to talk to them beforehand when we haven’t taken their clothes away, and they haven’t been fasting,” Birgenheier said. “They are in a better setting to ask questions and think about what their plan of care should be.”
Schommer added that patients coming in for surgery are often anxious and have put their lives on hold for this event. “They’re dealing with the unknown and they aren’t in control. They’ve had family come from out of town,” she said. “Education prior to the day of surgery will decrease patient anxiety. Information obtained during the pre-op clinic visit will result in decreasing case delays and case cancellations, which will improve the patient’s satisfaction.”
The process begins with the patient’s surgeon, who will send an order to the scheduling department at the hospital. He or she will include a screening tool that identifies whether the patient would benefit from attending the pre-op clinic – most often targeting patients with serious medical conditions.
During the pre-op visit experience, the patient pre-registers and becomes pre-approved for the surgery. A hospital registration staff member will escort the patient to the pre-op clinic where he or she will meet the preadmissions testing nurse to review health data. Nurse practitioner Laura Hildebrand, NP-C, conducts the one-on-one session to review the care plan and answer questions.
The pre-op clinic is offered at no extra cost to the patient and is open to all surgical patients who have questions about their care. Patients should set up their appointment for the clinic within 30 days of their surgery, usually about one or two weeks prior.
Having time to develop a rapport with the patient means better results for the patient, Birgenheier said.
“It is clear that a number of people will come in on the day of their surgery and just want to be put to sleep and do not want to have to think about what the optimal decision would be for them,” he said. “Yet when they are given time, they can talk about things and think through their options. They’re bound to have a better result.”
For more information about the pre-op education clinic, please call (970) 350-4898.
