What To Bring To The PACE Clinic Appointment
- An updated list of all medications, including the medication name, dose in milligrams and when the medication is taken
- Name and phone number of the primary care physician and any other specialists
- A list of any other hospitals at which evaluations for heart or lung disease or stroke were performed
What To Expect During The PACE Clinic Appointment
During the appointment, a healthcare provider will:
- Take a medical history
- Perform a physical exam
- Review pertinent tests ordered by the preop physician
- Discuss which medications should or should not be taken before and immediately after surgery
- Order additional tests that may be necessary before proceeding with surgery; lab tests can be performed the same day as the PACE Clinic appointment, but specialty tests, such as stress tests, sleep studies or echocardiograms, will need to be scheduled. The center will schedule additional testing to minimize surgery delays.
- Coordination of surgery plans with the surgeon, anesthesiologist and primary care physician
In most cases, surgery will not be delayed. But a common cold or a poorly controlled pre-existing medical condition, such as high blood pressure or diabetes, that could adversely affect surgical outcomes, may cause the surgery to be delayed. If a condition that requires additional treatment for medical optimization before surgery is identified, the PACE Clinic will notify the patient, the orthopaedic surgeon and the primary care physician. The PACE Clinic's preop physician will discuss the situation with the orthopaedic surgeon, who will determine if the surgery should be delayed.
Patients who need medication adjustments can work through the PACE Clinic, or they may need to follow up with their primary care physician for a modified or new treatment plan. Once the patient is deemed ready for surgery, a re-evaluation at the PACE Clinic may be necessary for some patients.
Preoperative Assessment Clearance Education Clinic
The Orthopedic Hospital's Preoperative Assessment Clearance Education Clinic was developed to help ensure complications after surgery are minimized or eliminated for all orthopaedic patients. Research has shown that many complications can be prevented if patients are better evaluated prior to surgery.
Additionally, the goal of the PACE Clinic is to educate patients about their surgeries to help ensure the overall surgical experience is positive. For most patients, the idea of surgery is frightening. But knowledge is power, and the more patients know about the before, during and after aspects of their surgeries, the less anxiety they feel and the better their outcomes. The preoperative evaluation process is designed to provide the information patients need to feel educated about and comfortable with the entire surgical experience.
The Education Process
As soon as patients know they need orthopaedic surgery, the education process begins. It includes:
- What to expect before, during and after surgery - in the hospital and at home
- What to expect upon arrival at the hospital
- How your pain will be managed
- Types of bandages, drains and/or tubes that will be used
- What to expect from the physical and occupational therapists
- What home equipment is needed and how to use it
- Attend Joint Camp to meet the anesthesiologist, pharmacist, physical and occupational therapists, nurses and other care-team members to discuss your individual plan of care
Physical and Occupational Therapy
Physical and occupational therapists will help prepare patients for surgery and assist them after surgery as they prepare to go home. Therapists will assist with exercise and walking programs and teach patients how to use special equipment, including crutches, walkers and raised toilet seats.
The Preop Evaluation
Each patient's potential risks are evaluated at the center by the preop team prior to surgery using a standard series of questions, which were designed to help the team understand all aspects of each patient's unique medical history. Because some patients are unaware they have a medical condition, it is important that the entire medical team understands each patient's risks and is involved in the development of a treatment plan designed to help minimizes those risks. The process is quite thorough and is completed in addition to any type of evaluation performed by the primary care physician.
Unless an underlying problem is identified that needs to be addressed by a specialist before surgery, the information gathered at the PACE Clinic appointment will be all that is needed, and the surgery can proceed as scheduled. If a referral to a specialist is needed, the PACE Clinic will coordinate an additional appointment with the patient's primary care physician or nurse practitioner. If additional medications are needed, these can be prescribed by the center's preop physician or nurse practitioner in coordination with the primary care physician.
The preop evaluation process includes:
- Complete review of each patient's unique medical issues and potential medical and surgical risks, as well as all test and consult results.
- A visit with the preop physician may be needed for further evaluation of any medical or surgical risk that were identified.
- A physical exam for each patient scheduled by the PACE Clinic.
- Additional tests, such as lab work, X-rays and an EKG are completed, if needed. Patients with high-risk medical conditions may also need to see a specialist prior to surgery.
- Scheduling of physical therapy evaluation to determine the patient's physical capabilities and to develop a recovery plan.
- Creation of an individualized care plan to reduce or eliminate risks and expedite recovery, based on each patient's unique medical and homecare needs.
- Surgeon determines appropriateness of patient donating his or her own blood prior to surgery for use during surgery.
- Hospital registration team contacts each patient to assist with the completion of preadmission paperwork.