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INFECTION PREVENTION
long-term therapy. In our sometimes-fragmented healthcare system, it's critical to
use the perioperative contact to improve
overall health. This requires some creative
and progressive resource allocation among
the surgical, anesthesia, endocrine and primary care clinicians.
Sometimes the only practical option for
urgent management of a pre-op patient with
high glucose is a referral to the emergency
department or pre-admission. Similarly,
insulin pumps may trigger an endocrine consult. This is an inefficient use of resources.
The medical management isn't usually complex, but it does require someone with the
confidence, time and authority to institute
protocols and adjust insulin doses. A clinician with diabetes management experience
"on loan" to the pre-op clinic may be a more
efficient and patient-centered model of care.
As payments for perioperative care become
more global in nature, this cooperation will
become more critical for financial viability,
as well as for good patient care. OSM
Dr. Olson (ron.olson@duke.edu) is medical director of pre-operative assessments at Duke
University Hospital in Durham, N.C.
S E P T E M B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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