Surgery Coordinator

From Thousand Smiles Wiki

Volunteer Surgery Coordinator

Responsible for surgery patient flow and problem solving at the hospital the day of surgery

SURGERY PATIENT FLOW FRIDAY AND SATURDAY

This position was originally created and performed by Christi Robbins and encompasses job functions for surgical patients on both Friday clinic and Saturday surgery at the hospital.

FRIDAY: Arrive to clinic at 8:00 a.m.

Remove ADMISSIONS CART from truck. You will need several supplies for both Friday and Saturday.

SURGERY HUB: This area will need at least 1-2 runners with at least 1 bilingual apart from the main HUB.

• Arrange a separate stand-up bin for the surgery patient HUB. This area works with the main HUB if (through triage) is determined that other areas such as x-ray, speech, audiology, or dentists need to see the patient. If so, the patient file must pass through surgery, residents, nurses, and pre-op photos before being released to other areas.
• IMPORTANT: take precaution to ensure patient files slated for surgery are given priority and do not get lost in the shuffle. These files must be later gathered and prioritized for Saturday morning surgery admissions.
• IMPORTANT: make sure surgery patients and files flow from the surgeons, to residents for H&P’s, to nurses, and then to pre-op photos. Upon return of file, make a list a list of lab patients (tube patients do not get labs unless he or she is having other surgery). You will need to refer to this list at a later date.

As patient files come from triage it is imperative that each file is given a 1) SmileTrain form, 2) a travel questionnaire, 3) and patient flow sheet for admissions and post-op prior to seeing the surgeons SEE BELOW FOR MORE SURGERY HUB RESPONSIBILITIES

SURGICAL AREA SET UP Arrange 2-3 tables for surgeons and team members

• Table set up
  • Each table needs 4 or so chairs
  • A flashlight
  • Tongue depressors
  • Latex gloves
  • Lab vests
  • Bottle of Purell sanitizer
  • Pens
  • Pad of paper
  • Surgery Today checklist forms
  • Consent forms (note there are three different consent forms 1) tubes, lip or palate repair, or graft).

Important: when the surgeons done with the files they should forward the file and patient to the next station (Resident Area) for further processing. If the resident area is backlogged, the patient files are to be placed in the resident area stand up folder holder and the patient and family asked to wait their turn outside.

RESIDENT AREA SET UP

• Table set up (usually 1 table, 4 chairs)
  • Provide all three consent types
  • Extra smile train forms
  • Stand up folder holder
  • Latex gloves
  • Thermometer (elevated temp may indicate problem-notify surgeon ASAP)
  • A scale
  • Bottle of purell sanitizer
  • A tape measure
  • BP cuffs to include infant, youth, and adult
  • Wrist bands for patent and parents

NEED at least 2 bilingual residents. Residents will:

• Make a patient list
• Verify consent was signed, if not, explain and provide the appropriate consent form (signed).
• Interview patient for completion of travel questionnaire. IF travel problems such as overnight accommodations or lengthy travel issues occur…the file is flagged by comment made on the (SURGERY TOMORROW) cover sheet as this may alter patient priority for surgery scheduling.
• Provide patient instructions and STRESS that if the child has ANYTHING to eat or drink prior to surgery the surgery WILL BE CANCELLED.
• Sign off SURGERY TOMORROW cover sheet
• Send patient file and patient to nursing station for pre-admission functions. If there is room at their table, forward file and patient; however, if there is no room, provide file to the nursing stand-up file holder and ask the patient to wait outside until called. OR…the residents can perform the following nursing functions in preparation for tomorrow’s surgery.
• Typically, the patient flow will continue to the nursing table whereby they can obtain height and weight information and begin pre-admission functions. IF they are overwhelmed and if time permits, the residents are encouraged to provide height, weight, check BP/temp, and complete patient flow sheet, and provide matching patient and parent ID bracelets that include patient name and ID no.
• If residents perform nursing functions below then the file and patient can go directly to Pre-op Photos. If there is a backlog, make sure the file gets put in the stand up file holder and patient asked to wait their turn outside.

NURSE AREA SET UP

• Table set up
  • Latex gloves
  • Scale
  • Measuring tape
  • BP cuffs (infant, youth, and adult)
  • Thermometer (elevated temp may indicate problem-notify surgeon ASAP)
  • Purell hand sanitizer
  • Wrist bands for patient and parent
  • Stethoscopes

NEED two Nurses at least one Bilingual (preferably two). Nurses will:

• Make a patient list
• Prepare the patient flow sheet in advance. Patient height, weight, temp are noted. IMPORTANT: if elevated or abnormal temp is noted. Let the surgeons know ASAP.
• Prepare patient and parent ID wrist bands.
• Sign off SURGERY TOMORROW cover sheet
• Send patient file and patient to pre-op photos. If there is room at their table, forward file and patient; however, if there is no room, provide file to the pre-op photo stand-up file holder and ask the patient to wait outside until called.

• Make a list of pre-op patients
• Get stuffed animals ready to distract the frightened children
• Photo patient for smile train grant and record card no.
• Sign off SURGERY TOMORROW cover sheet
• Return file to surgery HUB for labs and further instructions

SURGERY HUB

• Make a list of each patient
• Confirm SURGERY TOMORROW sheet boxes are initialed
• Make a separate list of LAB patients
• IMPORTANT: all labs must be completed by 2:00
• Confirm with driver (usually a Rotarian) how many lab patients his vehicle will hold...when enough patients, send a group for labs.
• Upon lab patient return, mark labs done on the SURGERY TOMORROW SHEET and confirm what other area needs to be done i.e. audiology, speech, or dentistry needs to be done. If nothing...let patient family know to be at the hospital at 6:30 in the morning and NO food or drink after midnight

Volunteer Drivers are needed to take patients to lab and also for those staying in town or at the mission. (The travel questionnaire may give this information) but usually the drivers already know who they need to take.

LABORATORIO BORBOLLA Riveroll 579 Zona Centro Ensenada, B.C. 22800

Jose Antonio Borbolla (Member Club Rotario Ensenada Centenaria) Phone (646) 178 36 94 Fax (646) 178 24 49 Emergency (646) 112 01 46

The volunteer surgery coordinator will bird-dog all the surgery files and place them in order according to the official surgical schedule as prepared by the surgeons and the OR Director. The hospital's nurse coordinator will advise how many surgical rooms will be available--usually three rooms.

ALL SURGERY PATIENT FILES MUST have H&P’s, pre-admission done, consent forms signed, pre-op photos done, and labs performed (tube patients do not get labs/photos). If not, the file is noted and flagged for Saturday morning completion.

The files are then transported from the clinic to the hospital by a designated surgery resident. The labs will usually be ready for review the night prior to surgery. Surgeons may elect to cancel some patients at that time.

SATURDAY

The volunteer surgery coordinator needs a NEXTEL (See Bob Chalfa) for communication between the hospital and clinic for supplies and equipment that may have been overlooked when loading.

The volunteer surgery coordinator will also need a driver available to go back and forth from hospital and clinic.

IMPORTANT INSTRUCTIONS FOR EVERYONE concerning the facility and the importance of respecting the hospital requirements of not wearing of scrubs outside the OR. DO NOT arrive to the hospital wearing scrubs if you intend on going in surgery. There is a changing room available. Come in regular clothes, change into your scrubs in the dressing rooms, and when taking breaks or going to lunch...please change back into your street clothing. Nursing staff in pre and post-op can work in street clothing or scrubs.

BATHROOM LOCKS: If one enters the bathroom and locks the door behind them...the doors must be MANUALLY unlocked otherwise you will exit and the door will shut behind you and be locked. This poses an inconvenience to everyone so please remember to manually unlock (and double check) the door before leaving.

• 8 walkie-talkies should be available for Saturday use at the hospital and are provided to:
  • OR Director
  • Surgery admissions/registration
  • Pre-op
  • Post-op
  • Runner
  • Spanish speaker/translator
  • Anyone who needs it

• Send cancelled patients home ASAP

Patients that are cancelled due to labs should be told ASAP. The surgeon responsible for making the decision to cancel will speak with the patient's parents. Remember these kids have not eaten so there should be no delay in this cancellation.

• Set up Admission desk
• Go outside and make a check-in sheet for those present.
• Arrange patient files in stand up folder according to room and patient priority no. i.e. room one, patient one...room two, patient one etc.
• Have nurses and residents begin admin procedures and confirm wristbands. If there are no wristbands...make new ones.

Need 1 resident (If any H&P’s need to be done) and one or two nurses. Residents are there only long enough to complete any outstanding H&P’s otherwise they are needed in surgery.

ORDER and PRIORITY OF ADMISSIONS Nurses/Residents should: 1) Check the first two tube patients 2) check room one, patient, one 3) check room two, patient one 4) check the remainder tube patients 5) then room one, patient two...room two, patient two... 6) check the remainder.

Normally admissions are complete by 9:00 or 10:00. Once completed...these nurses can be used in pre-and post-op

PRE-OP Will need at least one nurse (preferably capable of giving IV’s) Possibly one and at times two runners will be needed between pre-and post op. Runners will be responsible for getting patients from pre-op to OR and patients from OR to post-op. Runners will also go get the parents once the child gets to post-op.

• The pre-op cart needs to be placed in the pre-op room
• The first tube patients need to be ready.
• Nurses will gown and start I.V’s (confirm with OR Director if the anesthesiologist wants IVs.
• Listen for calls from the OR Director for patient no.
• A runner can be used to take the patient to OR the nurse can if time permits.
• Please no eating and drinking in front of the children.

POST OP Need at least one or two nurses for recovery and discharge (Monica usually discharges patients if she is here).

• the post op cart needs to be placed in the post-op room
• the nurses perform post op duties
• if stuffed animals are available...these should be given during recovery and discharge.
• During the slow times, the nurses can work ahead to mix the discharge medications. If they become overwhelmed...let the surgery coordinator know and he or she can get volunteers to help mix the medications.
• Rotarians usually provide sack lunches...these can be given to the families as they leave.
• Please NO eating or drinking in front of the children.

LUNCH AND SNACK TIME SHOULD BE COORDINATED TO MAKE SURE THAT THERE IS ADEQUATE COVERAGE OF DUTIES AT ALL TIMES.

The rotaries will provide lunch and after all have eaten a volunteer (or runner) is needed to transfer all the food to the ice chests in the lounge.

The volunteer coordinator usually reviews all post-op files.

Owner and Alternates

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