problem," says Dr. Caillouette.
Ensuring patients are suitable for surgery also requires more thor-
ough pre-op testing. Ms. White notes that in addition to the center's
standard pre-admission protocol, patients undergoing joint replace-
ment must get tested for MRSA within 30 days of surgery. "Surgeons
won't proceed if they test positive," she notes. "They reschedule it
until the patient
is decolonized
and cleared."
Though
exceedingly
rare, Ms. White
also says the
center has a plan in place if there's ever a conflict with the surgeon
over whether a patient is "relatively healthy" enough for the proce-
dure. "We consult with our anesthesia medical director on anything
that's out of our comfort zone," she says.
Home support
If a patient is 50 years old with a BMI of 29 and no comorbidi-
ties, but he lives alone, could he still be a candidate? Not likely.
"Patients need adequate social support if they're going home the day
of surgery," says Dr. Lee. "You still need a family structure or social
network that's conducive to recovery in addition to having living quar-
ters that don't put the patient at unnecessary risk."
You should establish — by simply asking or by visiting the home
— that patients will be returning to a safe space. Some facilities
even take the extra step to send physical therapists to the home a
few days before surgery to check the number of stairs and clear any
potential tripping hazards. "If your living quarters require you go up
J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 2 1
"A patient's attitude is an important,
if not the most important, thing."
— Gwo-Chin Lee, MD
