1. Pre-Surgical Testing Quality & Patient Safety Department

2. 2 “To every patient, every time, we will provide the care that we would want for our loved ones.” Table of Contents  GREETING/INTRODUCTION.........................................................................................................ROBERTA CORDARA  PERI-OP OVERVIEW………………………………………………………………………………DIANN DOBSON  ANESTHESIA OVERVIEW………….............................................................…………………..…DAN KESSLER  SCHEDULING PROCESS……………………………………………………………..…………….TRACIE BROWN  OFFICE TOOLS…………………………………………………………………………….…….….NANCY RIZER  PRE-SURGICAL TESTING OVERVIEW……………………………………………….…….…….BEVERLY BYE  PRE-SURGICAL TESTING…………..…………………………………………………….…..……BECKY TAYNOR  PEDIATRIC WEB-SITE ….………………………………………………………………………….KATE DEVAN

3. 3 “To every patient, every time, we will provide the care that we would want for our loved ones.” Binder

4. 4 “To every patient, every time, we will provide the care that we would want for our loved ones.” Patient Pamphlet

5. 5 “To every patient, every time, we will provide the care that we would want for our loved ones.” Top Ten Cases PROCEDURE#DESCRIPTIONCOUNT 3415D&C WITH HYSTEROSCOPY36 3628D&C W/HYSTEROSCOPY W/NOVASURE15 20671LAP HYSTERECTOMY VAG ASSIST/CYSTO11 1544CONIZATION CERVIX W/LASER5 19279 HYSTEROSCOPY OPERATIVE MYOSURE4 10068HYSTERECTOMY ABDOMINAL TOTAL/CYSTO4 2233MYOMECTOMY3 2067LAP HYSTERECTOMY VAGINAL ASSISTED (LAVH)3 1942INCISION AND DRAINAGE VULVAR ABCESS2

6. 6 “To every patient, every time, we will provide the care that we would want for our loved ones.” Policy FAQ Sheet  Policy states that all PAT information should be received by 72 hours (3 business days). If they are not received by 48 hours (2 business days) your case may be moved or adjusted at that time.  All PAT data should be faxed to the PAT department for review. No hand carrying information day of surgery.  All pages of the PAT information must have date of birth and patient’s name as identifiers for patient safety.  History & Physical must meet requirements of GBMC bylaws and the regulatory agencies. May not be older than 30 days NO exceptions.  EKG’s must be legible and have doctor’s signature. Within anesthesia guidelines. No exceptions. Labs per anesthesia guidelines are good for 60 days. No exceptions.  Patients coming from nursing homes: Case time must be 9am or later due to transportation.  If patients need a blood transfusion prior to surgery, they will need to be admitted the day before.

7. Periop Overview

8. 8 “To every patient, every time, we will provide the care that we would want for our loved ones.” Block Time (Coming Soon)

9. Anesthesia Overview

10. Scheduling Process

11. 11 “To every patient, every time, we will provide the care that we would want for our loved ones.” Scheduling A Case Please use the following guidelines for scheduling your surgery at Greater Baltimore Medical Center (GBMC). If you have surgery and your doctor does not have scheduled block time, please call GBMC at 443-849-6700 to speak with a scheduler about available dates and times. After a date and time have been selected you may send your posting request via www.gbmc.org/surgicalposting. If your patient needs a pre-op testing appointment, please request it with the scheduler at the time of your phone call or request an appointment when sending the case via the scheduling website. You will be contacted by the scheduler with a date and time for the patient.www.gbmc.org/surgicalposting If your doctor has scheduled block time at GBMC, you may send your request for surgeries scheduled within your block time without calling our scheduling line. If your patient needs a pre-op testing appointment, please call to schedule or request an appointment when sending the case via the scheduling website. You will be contacted by the scheduler with a date and time for the patient.

12. 12 “To every patient, every time, we will provide the care that we would want for our loved ones.” Scheduling A Case Upon arrival for the pre-op testing appointment the patient should report to the Emergency Department Registration Desk and inform the registrar they are for a pre-op appointment. After registration is complete, the patient will be escorted to the Pre-Admission Testing Department by the Patient Access Representative. All surgery requests will be entered via the www.gbmc.org/surgicalposting as a means to communicate them to the surgery scheduler. This provides the easiest and most complete way to send surgical request. Instructions to schedule a case are provided in your handbook.www.gbmc.org/surgicalposting If you have any questions, please call GBMC Surgical Scheduling: 443-849-6700 Thank you

13. 13 “To every patient, every time, we will provide the care that we would want for our loved ones.” Procedure List

14. 14 “To every patient, every time, we will provide the care that we would want for our loved ones.” Surgery Scheduling Process HOW TO SCHEDULE AN ELECTIVE SURGERY FOR BLOCK SURGEONS Log onto GBMC web site (www.gbmc.org/surgicalposting) to complete all fields for surgical case. This form will not be processed unless all fields are completed.www.gbmc.org/surgicalposting The GBMC Surgical Scheduling Department will schedule the case when they receive the completed form. The surgeon’s office will receive a Surgery Scheduling Form via an automated fax with an assigned case confirmation number. Retain the Surgery Confirmation Form with case confirmation number for reference. HOW TO SCHEDULE NON-BLOCK TIME Call the GBMC Surgery Scheduling Department at 443-849-6700 to request date and time. This will reserve a time on the schedule. The case must be sent within 24 hours. To complete the scheduling process log onto the GBMC web site (www.gbmc.org/surgicalposting) and complete the form.www.gbmc.org/surgicalposting

15. 15 “To every patient, every time, we will provide the care that we would want for our loved ones.” Urgent/ Emergent Case Classification

16. 16 “To every patient, every time, we will provide the care that we would want for our loved ones.” Surgery Scheduling Process CONFIRMATION PROCESS The GBMC Surgery Scheduling Department will send a fax confirmation of all surgeries scheduled 3 days prior to surgery. Review and return the form to 443-849-3914 acknowledging all cases are correct. CANCELLATIONS OR CHANGES To change or cancel a case within 72 hours, call the GBMC Surgical Scheduling Department 443-849-6700. To change or cancel a surgery beyond 72 hours log onto the GBMC web site and submit form to process (www.gbmc.org/surgicalposting).www.gbmc.org/surgicalposting DO NOT SEND CANCELLATIONS FOR THE NEXT DAY VIA THE WEBSITE. Cancellation will require an explanation.

17. 17 “To every patient, every time, we will provide the care that we would want for our loved ones.” Online Form

18. 18 “To every patient, every time, we will provide the care that we would want for our loved ones.” Surgery Scheduling Process NEXT STEPS FOR PATIENT Once a patient is scheduled, they will be contacted by Registration and Pre-Admission Testing (PAT). Registration will update the patient’s demographic information and will attempt to collect any co-pays, deductibles, or co-insurance, which are due at time of service. A PAT nurse will contact the patient for the nursing assessment. The nurse will use pre- anesthesia guidelines to determine if the patient needs to be scheduled for a PAT visit. If so, the patient will be given a time for the PAT visit by the PAT nurse. CONTACT INFORMATION Scheduling Office Hours: 7:30 am – 5:00pm 443-849-6700 REMEMBER A CASE WILL NOT BE CONSIDERED SCHEDULED UNLESS A SURGERY SCHEDULING FORM IS COMPLETE AND A CASE CONFIRMATION IS RETURNED TO YOU

19. 19 “To every patient, every time, we will provide the care that we would want for our loved ones.” Block Release Form

20. 20 “To every patient, every time, we will provide the care that we would want for our loved ones.” Google Calendar

21. Office Tools

22. 22 “To every patient, every time, we will provide the care that we would want for our loved ones.” Office Tool Suggestions Please have patient fill out Pre-Admission Questionnaire for ease of case scheduling and for ordering pre-surgical testing requirements based on the brief assessment. Please make copies of the enclosed assessment. We are also giving you a pamphlet “Preparing for Surgery”. This is to be filled out and given to every surgical patient. Additional copies can be obtained through GBMC Marketing Department. Surgical Services

23. 23 “To every patient, every time, we will provide the care that we would want for our loved ones.” Office Assessment Tool

24. 24 “To every patient, every time, we will provide the care that we would want for our loved ones.” Anesthesia Requirements

25. 25 “To every patient, every time, we will provide the care that we would want for our loved ones.” Arrival Times GOR ALL PATIENTS ARRIVE 2 HOURS BEFORE SCHEDULED TIME. THIS INCLUDES WSC PATIENTS DURING CONSTRUCTION. SSC ALL PATIENTS ARRIVE 1 HOUR AND 30 MINUTES AHEAD OF SCHEDULED TIME. EXCEPTIONS PEDIATRIC PATIENTS (12 AND UNDER) 1 HOUR PRIOR TO CASE.

26. 26 “To every patient, every time, we will provide the care that we would want for our loved ones.” Important Phone Numbers Administration for Surgical Services Director……………………………………………………………………………………………………………………………………………..443-849-6086 Anesthesia/Peri-Operative Medical Director Main Line…………………………………………………………………….443-849-2202 Operating Rooms General Operating Room (GOR) Manager…………………………………………………………………………………………………………………….443-849-6122 Main Desk………………………………………………………………………………………………………………….443-849-2240 Pre-Op……………………………………………………………………………………………………………………….443-849-3561 PACU Manager………………………………………………………………………………………………………..…443-849-8197 Main Line……………………………………………………………………………………………………….………….443-849-2250 Sherwood Surgical Center (SSC) Manager…………………………………………………………………………………………………………………….443-849-8158 Main Desk………………………………………………………………………………………………………………….443-849-2420 Pre-Op…………………………………………………………………………………………………….....................443-849-2516 PACU………………………………………………………………………………………………………………………....443-849-2756

27. 27 “To every patient, every time, we will provide the care that we would want for our loved ones.” Campus Map You can view all locations throughout Greater Baltimore Medical Center using our interactive map website: www.gbmc.org/interactivemapwww.gbmc.org/interactivemap

28. Pre-Surgical Testing Overview

29. Pre-Surgical Testing

30. 30 “To every patient, every time, we will provide the care that we would want for our loved ones.” 100 CHARTS REVIEWED FOR SURGICAL CANCELLATION REASONS – TOP 3 ANSWERS ON THE BOARD GBMC P.S.T. FEUD GBMC P.S.T. FEUD

31. 31 “To every patient, every time, we will provide the care that we would want for our loved ones.” 100 CHARTS REVIEWED FOR SURGICAL CANCELLATION REASONS – TOP 3 ANSWERS ON THE BOARD GBMC P.S.T. FEUD DR REQUEST

32. 32 100 CHARTS REVIEWED FOR SURGICAL CANCELLATION REASONS – TOP 3 ANSWERS ON THE BOARD GBMC P.S.T. FEUD DR REQUEST FURTHER WORK UP

33. 33 “To every patient, every time, we will provide the care that we would want for our loved ones.” 100 CHARTS REVIEWED FOR SURGICAL CANCELLATION REASONS – TOP 3 ANSWERS ON THE BOARD GBMC P.S.T. FEUD DR REQUEST FURTHER WORK UP PATIENT REQUEST

34. 34 “To every patient, every time, we will provide the care that we would want for our loved ones.” Top 10 Day of Surgery Cancellations #Cancellation ReasonQuantity 1Dr Request42 2Further work up29 3Patient Request28 4Patient Ill22 5Weather20 6Condition Improved10 7Condition Deteriated6 8Insurance6 9PT Took Medication5 10Cardiac Clearance4

35. 35 “To every patient, every time, we will provide the care that we would want for our loved ones.” Pre-Operative Phone Calls CURRENT MADE BY THE PRE-OPERATIVE NURSES FUTURE WILL BE DONE BY PRE-SURGICAL TESTING NURSES

36. 36 “To every patient, every time, we will provide the care that we would want for our loved ones.” Anesthesia Requirements

37. 37 “To every patient, every time, we will provide the care that we would want for our loved ones.” Abnormal Labs

38. 38 “To every patient, every time, we will provide the care that we would want for our loved ones.” Medication List

39. 39 “To every patient, every time, we will provide the care that we would want for our loved ones.” H&P Form

41. 41 “To every patient, every time, we will provide the care that we would want for our loved ones.” Pediatric Surgical Education For information regarding pediatric surgery at GBMC Sherwood Surgical Center, please log onto http://www.gbmc.org/sherwood to watch a short video. http://www.gbmc.org/sherwood