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Tell Your Patients to Drink Up - Outpatient Surgery Magazine - March 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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"Patients received stock prescriptions for pain medications at dis- charge because there was no infrastructure in place to assess their condition and adjust their care plan," says Padma Gulur, MD, execu- tive vice chair of operations and performance at Duke Anesthesiology. "We saw a real opportunity to examine the surgical episode of care and explore ways we could do better." Two years ago this month, she helped launch a perioperative pain care clinic with the goal of personalizing post-op pain management, minimizing the use of opioids, reducing the amount of time patients spend in recovery and increasing their overall satisfaction. Her large health system had the means and need — it treats 60,000 surgical patients each year — to launch a dedicated post-op pain clinic, but you can implement a similar program on a smaller scale. The key is to focus on the unique pain management needs of your patients weeks before procedures instead of relying on a cooker-cutter approach on the day of surgery that's often ineffective and unsafe. From start to finish Dr. Gulur and a team of anesthesiologists, who are fellowship-trained in pain management, run Duke's clinic. A member of the team meets with patients as soon as possible after surgeries are scheduled and is available to support their recoveries for up to 90 days post-op. During pre-op appointments, they ask patients about their health histories, lifestyles, medication use and expectations of surgery and recovery. It's during those initial meetings with patients that they establish personal connections, learn about their specific pain man- agement needs and begin implementing the 3 essential elements of the program: • Medical. Dr. Gulur says chronic opioid users must be gradually weaned off of the painkillers before surgery because it's often neces- M A R C H 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 1 7

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