The health status of the individual being considered for
outpatient surgery is determined by the continuous collection
of data. Only patients who are Class I, Class II, or with
special clearance from the Medical Director, Class III, will
be considered eligible for outpatient surgery procedures. A
patient having outpatient surgery is expected to be able to
provide self-care upon discharge, with the assistance of a
family member and to be able to achieve pain control via the
use of oral analgesia.
The medical staff member will contact the patient's primary
care physician regarding serious pre-existing medical
conditions for clearance prior to surgery. If the contact
has been verbal, this will be documented in the History and
Physical report or as a part of the pre-operative anesthesia
The pre-operative diagnostic procedures for each patient is
individualized according to the patient's condition, surgical
procedure, and physician's preference.
All laboratory work must be drawn no earlier than 7 days
prior to the surgical procedure. The pre-admission
laboratory tests are to be completed prior to patient's
arriving for elective outpatient surgery.
Except when the surgical procedure is for the treatment of a
specific infection, patients for outpatient surgery shall be
free of infection at the time of surgery.
1. The pre-operative work-up, if any, shall include a
patient interview with appropriate history and physical
examination, and as indicated, consultation with primary
care physician, and diagnostic studies relative to the
planned intervention. The following will be discussed
with the patient, as appropriate:
A. Current medical diagnosis and proposed treatment;
B. Presence of pre-existing medical conditions which
affect patient's fitness for the planned
C. Understanding by patient of the expected results of
the planned procedure;
D. Historical response to anesthesia, illness,
hospitalizations, and/or procedures;
E. Family history of anesthesia complications
F. Results of diagnostic studies, if any;
G. Special needs assessment (i.e., vision, hearing,
speech, home/caregiver situation).
Food restrictions including NPO, medications (if any) to
be taken prior to surgery/procedure and any preparations
needed, such as skin prep scrubs, enemas will be
discussed and carefully explained to the patient.
2. The following tests are guidelines for required
diagnostic procedures, with appropriate consideration of
the patient's age and/or co-morbidity:
A. Laboratory: CBC, UA, PT, PTT, Electrolytes; urine
for pregnancy testing, if applicable
B. X-ray: Chest film, if indicated; acceptable up
to 90 days if patient is asymptomatic.
C. Other: EKG
3. When contacted to confirm surgical arrangements, the
patient will be encouraged to ask questions.
The patient should be informed that any outpatient procedure
may require inpatient admission to the hospital, in the event
of unforeseen circumstances.
Approved By Governing Board