Preparing and planning for surgery

Most surgical procedures are planned ahead of time. This allows for the parties involved (patient, surgery center or hospital, surgeon, anesthesia provider if needed) to prepare and plan before the surgery. This article focuses on surgical facility planning, but is based on the processes used by Prescott Outpatient Surgical Center (POSC).

Preparation, including financial, completion of information needed by doctors and facility, physical preparation, and planning for post-surgery can make everything go much smoother, and reduce the possibility of last minute problems or cancellation.

  1. Paperwork: This typically includes a medical history recap (similar to what doctors ask for), current medication list (to prevent things like excel bleeding during surgery as a result of blood thinners), privacy policies, advance directives/medical power of attorney, financial liability, etc. Patients have advance directives (regarding transfusions, resuscitation, medical decision making, etc.) must give copies to the facility if they want them adhered to. Medical history and medication information provides anesthesia providers information needed to provide safe and appropriate doses of medications.
  2. Pre-Surgery Preparation: At a minimum, patients will likely be asked to have no food or water six hours prior to surgery. Depending on the procedure being performed, there may be additional requirements. For instance, preparation for colonoscopies includes a cleansing of the digestive tract. This preparation is not particularly “fun,” but is extremely important. Non-compliance likely will result in the cancellation or rescheduling of the procedures. There have been times when patients state they’ve done all preparations, and it results in a partially completed procedure being cancelled mid procedure (and an intense OR cleanup).
  3. Instructions for post-surgery care: Patients are required to arrange for someone responsible to drive them home and spend 24 hours with the patient. POSC will not allow patients to drive themselves home or even take a cab if they do not have a responsible person with them. This has become a contentious point for some patients, but this is never compromised. In the end, it is for the patient’s safety.
  4. Financial planning: Every patient should know what their insurance pays and what their financial responsibility is. POSC always asks for the patient’s share before surgery. Since all procedures done at POSC are elective, there are some financing options available like CareCredit. Increasingly, insurance plans have higher deductibles and maximum out of pocket amounts that are the responsibility of the patient. If patients assume they will not have to pay up front, the scheduled procedure could be cancelled.
  5. Plan for the unexpected: In particular, surgeons can run ahead of or behind schedule. If this happens and POSC staff is aware, patients are contacted and asked if they can either come in earlier or later than originally scheduled. Schedules are created based on historical average lengths of procedures. However, every procedure and every patient is different. Once the surgeon “cuts,” they don’t know what they will find. Patients need to be “patient” when waiting for surgery. The anxiety of waiting should be offset with the confidence that the surgeon will always take the time needed for the patient to receive the highest care available. When waiting, this can be reassuring.

With proper planning and preparation, a “not so fun” day will go more smoothly and without problems.