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Ideas That Work
No Forms to Fill Out on Day of Surgery
Melonie Marchak
Publish Date: October 10, 2007   |  Tags:   Ideas That Work

Melonie Marchak, RN, BSN Our facility designed a folder to distribute to utilizing surgeons' offices. On the front of the folder is our logo and on each inside pocket a list of surgeons organized by specialty. Two pockets (one on the left inside of the folder, one on the right) contain all the pre-op forms the surgeon and patient need to complete before the patient's arrival at our surgery center. There are five pages in the left pocket for the physician to fill out:

Melonie Marchak, RN, BSN\

  • Page 1 is our surgical scheduling form, which the surgeons's offices fax to us after they've scheduled a patient with our facility, as confirmation. It also includes the primary care provider's name, where the patient has gone for pre-admission testing (if any), date of birth and type of surgery. After the procedure, OR time needed and any special equipment used - such as implants, allografts or imaging - is documented on the surgical scheduling form, as are the CPT or ICD-9 code, insurance information and whether the pre-authorization has been completed.
  • Page 2 contains the minimum requirements for pre-admission, a policy our anesthesiologist developed. It includes such tests - and results, if needed - as a chest X-ray for patients over 60, HCG and EKG on all patients over 40 and no labs on healthy males under 40.
  • Page 3 is a standard consent for procedure.
  • Page 4 is consent to treat, which authorizes billing and release of medical records.
  • Page 5 is a physician order form. That way, if the surgeon wants to order pre-op antibiotics, we know how to get started on them.

In the right pocket, there are seven pages for the patient to fill out or read:

  • Page 1 is a letter to patients from the medical director, welcoming them to and explaining the facility.
  • Page 2 contains insurance requirements for referrals to remind patients that a referral may be needed, that they may need to obtain it and that they will receive separate bills from the physician and anesthesiologist - and possibly from the lab if pathology is sent.
  • Page 3 is a patient demographic form including date of birth, gender, contact information and all-important insurance information.
  • Pages 4 and 5 are a health survey to get a brief physical history as described by the patient.
  • Page 6 is an explanation of patient's rights, including HIPAA information.
  • Page 7 contains instructions for the day of surgery, such as not eating or drinking, what clothes to wear, medications they can take and when to arrive at the surgery center.

Using this packet system, patients need only arrive 30 minutes before a procedure with packet in hand, which occurs 97 percent of the time.

Wanda Moratelli
Business Administrator
Ambulatory Care Center
Vineland, N.J.
writeMail("[email protected]")

ID badges have multiple uses
I make staff ID badges for our surgery center using a greeting card program that came installed on my computer's hard drive. Many people have digital cameras today, so it isn't difficult to find one to use to take the pictures. Set the resolution on the camera to "high" or "best" (mine is a 2.2 mega pixel camera). If you don't have access to a digital camera, you can scan a hard copy of a photo and crop out all but the subject.

The cost is minimal because I used photo paper I already had on hand. It gives the best printing results - the ink doesn't run, the pictures look sharper and the paper lasts longer. If you're buying the paper new, you can get a 15-sheet package for about $15, and you can fit 10 badges on a sheet.

Then I just cut them to size and stick them to our proximity badges - which we use to allow and track entry into our building - using double-sided tape. Since the badges are just passed in front of a sensor, we don't have to worry about scratching them in a badge-swipe system. However, if that were a problem, we could use a clear peel-and-stick laminate that comes in a roll (cost: about $10). I use it at home for protecting some older photos that I've digitally restored.

Our customers really seem to like the badges. Our motto, "Treating patients like family," is well accepted by employees and patients. And wearing it is a great reminder of what we staff are there to do.

Another option with the ID badge is to simply cut the pictures to the desired size and laminate them, leaving a 1/8-inch border on each side of the picture. You can buy rectangular hole punchers and badge clips at any craft store or office supply store. The advantage of this option is that you can attach (either by glue stick or double-sided tape) any kind of helpful info, such as local pharmacy numbers or acronyms such as RACE (pertaining to fires). The options are only limited by the users.

Paul Bernard, RN
OR/PACU/Safety Officer
Panama City Surgery Center
Panama City, Fla.
writeMail("[email protected]")

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