{"id":4962,"date":"2015-12-16T00:00:00","date_gmt":"2015-12-16T07:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2015\/12\/16\/pre-procedure-services-moves-clinic-expands-mission\/"},"modified":"2017-09-15T10:22:48","modified_gmt":"2017-09-15T16:22:48","slug":"pre-procedure-services-moves-clinic-expands-mission","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/pre-procedure-services-moves-clinic-expands-mission\/","title":{"rendered":"Pre-Procedure Services moves clinic, expands mission"},"content":{"rendered":"
<\/div>
One of seven exam rooms in the new clinic that were remodeled from patient rooms in what was the Medical Intensive Care Unit.<\/figcaption><\/figure>\n

In the latest of a long-running series of relocations and remodelings at University of Colorado Hospital, the Pre-Procedure Services Clinic moved from the sixth floor of the Anschutz Outpatient Pavilion (AOP) to the second floor of Anschutz Inpatient Pavilion 1 on Dec. 8. The clinic, which is responsible for preparing patients for surgeries, now occupies a space that formerly housed a 10-bed section of the Medical Intensive Care Unit (MICU).<\/p>\n

Pre-Procedure Services, which had shared its space with several others in the AOP, is now a self-contained clinic. It has its own waiting area; seven exam rooms (up from five); a consultation room; work areas for staff, case managers, and nurse practitioners; and a call center for staff who contact and answer questions for patients prior to surgery. There is also a room for EKG testing.<\/p>\n

Staff in the clinic\u2019s Call Center contact patients prior to inpatient and outpatient procedures to solidify details.<\/figcaption><\/figure>\n

The project made use of the old space by retaining many of the former inpatient rooms. But the remodeled exam rooms now have comforting natural scenes affixed to the doors. Movable walls created the work rooms and call center, and visitors are welcomed at the front door by a waiting room and a new front desk.<\/p>\n

Work on the project began last summer, said the clinic\u2019s charge nurse, Karla Fauria, RN, who was the point of contact for staff and other services. The move began Friday, Dec. 4, and the clinic was closed for just one day, Dec. 7, to finish supply restocking, furniture moving, and so on, before reopening in the new space the following day.<\/p>\n

\"\"
Karla Fauria (left) and Christine Woodman, charge nurse and nurse manager, respectively, of the Pre-Procedure Services Clinic, in the workroom of the clinic\u2019s new space on the second floor of AIP 1.<\/figcaption><\/figure>\n

The move made geographic sense, as it places Pre-Procedure Services a short distance from the hospital\u2019s ORs and anesthesiologists, who play an important role in the clinic\u2019s work. Surgery Check-in and the Pre-op and Post-Anesthesia Care units are also close by. But the relocation also involves redefining the services the clinic will offer, said Christine Woodman, RN, MSA, nurse manager of Pre-Procedure Services and Outpatient Surgery.<\/p>\n

Closer contact<\/strong><\/p>\n

Already in the works is expansion of the pre-operative phone calls to patients, Woodman said. The process prior to the move was for Call Center staff to contact patients four days ahead of their procedures to go over instructions, obtain medication lists, and confirm schedules. It all typically took about 10 minutes.<\/p>\n

The Call Center vastly improved patient satisfaction in 2009<\/a> by giving patients their time of surgery four days in advance of the surgery date. But the relatively short calls, coupled with tight pre-surgery time frames, Woodman said, sometimes didn\u2019t catch problems that cropped up the day of the procedure. That meant costly delays or cancellations that were also dissatisfiers for both patients and providers.<\/p>\n

\u201cThe short calls allowed no time to obtain a patient\u2019s medical history,\u201d Fauria said. \u201cThere were sometimes cardiac abnormalities or histories of high blood pressure that we were not aware of.\u201d<\/p>\n

The new process aims to head off those problems. Nurse practitioners will still see high-acuity patients, who make up about one-quarter of the surgical volume, in advance. But nurses in the Call Center will contact the others two weeks ahead of time, Woodman said, and complete a detailed review of their medical history, medication list, and instructions for surgery. They will also help to schedule patients for lab tests and EKGs, to catch problems ahead of time that would snarl schedules on the day of surgery. Patients can also walk in to the clinic for these tests, Woodman said.<\/p>\n

The new \u201cpre-anesthesia testing\u201d process has been rolled out to the Surgical Oncology, Urology, and Orthopedics clinics, Fauria said. All surgical clinics are slated to come on board next spring, she added.<\/p>\n

Home, sweet home<\/strong><\/p>\n

\"exam
Exam room doors are brightened by natural scenes.<\/figcaption><\/figure>\n
\"Selena
Medical assistant Selena Lopez works at the front desk of the clinic on its second day of operation in the new location.<\/figcaption><\/figure>\n

These changes are only one part of a broader effort to create a \u201cperioperative surgical home\u201d designed to prepare patients even more thoroughly for surgery and ensure a good recovery after it, Woodman said.<\/p>\n

The idea aims to improve patient care across the board and to support the hospital\u2019s participation in the Centers for Medicare and Medicaid Service\u2019s \u201cComprehensive Care for Joint Replacement Model<\/a>,\u201d or CJR. That program, which is scheduled to begin in April, will give hospitals a flat \u201cbundled\u201d payment for knee- and hip-replacement procedures. Hospitals will be responsible \u2013 and financially at risk \u2013 for managing the patient through a 90-day \u201cepisode of care,\u201d including care provided at other facilities. The cost of hospital readmissions will come out of the bundled payment.<\/p>\n

An important component of the perioperative surgical home is \u201cpre-habilitation\u201d to \u201cprepare the patient ahead of the surgery more thoroughly,\u201d Woodman said. That might include bolstering nutrition, monitoring fluids, testing exercise tolerance, encouraging weight loss, identifying potential airway problems, providing smoking cessation, managing pain, and many other factors.<\/p>\n

\"EKG
An EKG machine in the clinic is available for patients who walk in for pre-procedure testing.<\/figcaption><\/figure>\n

Tom Gronow, the hospital\u2019s chief operating officer, said the Pre-Procedure Services Clinic move is an integral part of the strategy for pre-habilitation and participation in the CJR.<\/p>\n

\u201cThe goal is to more effectively prepare patients for surgery,\u201d he said.<\/p>\n

The move to comprehensive care also demands that hospitals continue to assist patients after their procedures, which is key to limiting their lengths of stay and reducing their risk of readmission. Post-surgical services might include calls to check on incisions, pain levels, medications, and other needs, Woodman said.<\/p>\n

\u201cThe idea of the perioperative services home is to optimize treatment for patients ahead of time and during the surgery, and follow up with them after they leave the hospital,\u201d she said. “The current model leaves the patients with minimal multi-disciplinary follow-up once they go home from surgery. We are creating a smoother continuum of care with better outcomes and follow-up care post-surgery.”<\/p>\n","protected":false},"excerpt":{"rendered":"

In the latest of a long-running series of relocations and remodelings at University of Colorado Hospital, the Pre-Procedure Services Clinic moved from the sixth floor of the Anschutz Outpatient Pavilion (AOP) to the second floor of Anschutz Inpatient Pavilion 1 on Dec. 8. The clinic, which is responsible for preparing patients for surgeries, now occupies […]<\/p>\n","protected":false},"author":2143,"featured_media":2042,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[321,320,702],"class_list":["post-4962","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-comprehensive-care-for-joint-replacement-program","tag-joint-replacement","tag-surgical-care"],"acf":[],"yoast_head":"\nPre-Procedure Services moves clinic, expands mission - UCHealth Today<\/title>\n<meta name=\"description\" content=\"In the latest of a long-running series of relocations and remodelings at University of Colorado Hospital, the Pre-Procedure Services Clinic moved from the sixth floor of the Anschutz Outpatient Pavilion (AOP) to the second floor of Anschutz Inpatient Pavilion 1 on Dec. 8. 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