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No More Empty Beds - Outpatient Surgery Magazine - February 2020

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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The results prompted us to revamp our system for contacting patients before they arrive at our facility for surgery. • Anesthesia involvement. You can review all the charts you want the day before a patient's surgery, but it's nothing like talking to the patient. Who talks to the patient is also important. A perioperative nurse will read a chart differently than an anesthesia provider will. A CRNA will notice, for example, that the patient doesn't have cardiac clearance, and had a cardiac event six months ago. The scheduling surgeon or the perioperative nurse might not have picked up on that important cause for concern. Using a CRNA to make the call as opposed to an anesthesiologist is a more efficient use of resources. • Tag team calls. Perioperative nurses still contacts patients the day before their scheduled procedures and go through the usual script — when and where to show up, which medications to take and which not to take, when and what to eat and drink, what to wear, what to bring and so on. Once nurses are finished, they hand the phone to CRNAs (both are on the same call, so we don't bother the patient twice), who perform pre-op assessments and, if there are any red flags, immediately consult with the anesthesiologist. • Scripted questions. In order to give CRNAs as many tools as pos- sible to discern disqualifying issues during conversations with patients, we developed a protocol in close cooperation with our department of anesthesia. This assessment form, based on a validated and reliable anesthesia script, helps CRNAs examine and evaluate sur- gical patients over the phone. They can uncover things like a questionable medication regimen, outdated lab results, a need for an in-person consultation, the lack of a specialist's clearance, new symptoms, new diagnoses and much more. During our study, for example, a CRNA noticed a patient's breathing pattern was peculiar over the phone and brought it up 3 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 0

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