Transition from preoperative to perioperative clinic presents challenges and opportunities

The Role of a Preoperative Clinic in the Implementation of a Perioperative Surgical Home Program
Wednesday, 10:15-11:45 a.m.
Mezzanine 14A-B.

Leslie Garson, M.D.

Leslie Garson, M.D.

More preoperative clinics are looking at becoming perioperative clinics and becoming part of a Perioperative Surgical Home (PSH) program. A session today will feature four presentations looking at what is required in that transition and what hurdles may need to be cleared in the process.

“We hope to show how to integrate an existing preoperative clinic into a Perioperative Surgical Home program,” said Leslie Garson, M.D., Associate Clinical Professor in the Department of Anesthesiology and Perioperative Care at the University of California, Irvine, School of Medicine. “The Role of a Preoperative Clinic in the Implementation of a Perioperative Surgical Home Program” will be presented from 10:15 to 11:45 a.m. today in Mezzanine 14A-B.

The classic preoperative clinic is a data-gathering location, but a perioperative clinic will have a greater focus on working with patients to improve outcomes.

“It involves communicating with patients, patient expectation management, optimizing patients prior to their surgical procedures and educating them about smoking cessation and better nutrition preoperatively and postoperatively, and suggesting increasing exercise, even if it is just walking. All of these interventions can lead to better results,” Dr. Garson said. “We need to try to change the culture of what the nurses, nurse practitioners and physicians working in the clinic currently do to one where they engage with the patients more effectively before surgical procedures.”

Barriers to a smooth transition likely will come up, he said. These include changes in workflow, culture, expectations of those working in the clinic and patient expectations.

“Also, you have to tabulate, measure and report metrics that define a successful implementation into a PSH program,” Dr. Garson said. “How do you define what you are doing? How do you determine what the metrics are? How do you measure the metrics and how do you report them? If you put resources into this kind of transition, you want to exhibit that you are getting a return on investment of resources.”

Changing to a culture of shared decision-making with patients, clinic staff and surgeons is a challenge.

“It is a work in progress,” Dr. Garson said. “We are improving and making changes as we go along. We are trying to improve our processes, be more efficient, enhance workflow and have better outcomes for our patients. It takes time and commitment.”

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