Outpatient Surgery Magazine

BSN, perioperative manager at Stony Brook Eastern Long Island Hospital in Greenport, N.Y., says all patients are warmed using warmed blankets or forced air, regardless of procedure type. She says the costs are negligible, and thinks the money saved due to shorter recovery times more than offsets the nominal expense of warming. The OR's room temperature is a factor for 38% and the age of the patient is a consideration for 37%. Nearly 36% take the type of anes- thesia into account, and a patient's ASA status and pre-existing medical conditions are a factor for one- third of respondents. A patient's BMI is a considera- tion by 15% of those who responded, and nearly 4% weigh the patient's gender. Ms. Robinson says the warming practices she uses are patient- and procedure-specific. "People come to us from outside in the 100- degree Texas heat to the lobby, then to the waiting room, then to our OR, which is around 64 degrees," she says. "All of those transitions have an effect on the body, and a little old lady with a low fat content will handle that differently than a morbidly obese man." Costs offset by savings Cindy McClement, BScN, RN, manager of perioper- ative services at Trillium Health Partners in Mississauga, Ontario, Canada, says her facility spends several thousand dollars a month on patient warming. They routinely warm patients, and Ms. McClement says there are economic as well as clini- cal benefits. Cost savings from patient warming can be hard to quantify, but are obvious. Clinical complica- tions increase costs to patients and facilities. Warming has been shown to reduce those expen- sive complications. Ms. Robinson estimates that warming costs her facility somewhere close to four figures a year, which includes having to replace the popular gel packs that mysteriously disappear. "They're 150 bucks each, but the patients love them," she says. "I can't prove it, but I know some patients have taken them home." The gel pads are thick, comfortable and wash- able. "They're expensive, but you know what? That's not how I think about it," says Ms. Robinson. "I think about it like, if our patient is shivering or gets an infection because she's cold, now I have a patient transfer, which is $1,200 to $1,500 for the ambulance alone." And such transfers could include regulatory fol- low-ups, which take time, and thereby cost money. Ms. Robinson says the warming at Advanced Surgical must be working, as there have been virtu- ally no SSIs or hospital transfers in the 3 1/2 years she has been there. While it might sound overly simplistic, Ms. Robinson says it's important to keep in mind that patients are coming in for surgery, so they're stressed. Most aren't thinking about the risks of clinical complications. After it's all over, all they know is that the procedure itself went well — and what they remember most is that they were warm and cozy throughout the process. "Some of our patients go to aftercare at the doc- tor's office next-door and they stop in with cards, brownies and hugs as a thank you," says Ms. Robinson. "When that happens, we know we've done our job. Their comfort level when they were here is a huge part of that." OSM 3 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 9

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