General Information

Sent on behalf of Dr. van der Vyver

Pre-admission clinic (2th floor East wing)

• Staffed by MD and Anesthesia NP (Jiao Jiang) 5days/week

• Pick up list of all cases booked for day from PAC clerks (Lucy, Kris and Michelle) 

• Clinic starts @ 08h00

• Arthroplasty patients are seen on avg. 2 weeks preop; non-arthroplasty patients 2-7 days.

• Connexal (HC version of TrackPAC) are used to ensure patient flow - ask clerks in PAC for a quick orientation. 

• Zoom interviews - max 4x/day; will be listed on as ‘zoom’

• Nursing TL lead changes every week - when communicating, please use HCPOPNursingStaff@sunnybrook.ca 

• Criteria for anesthesia consults

• Please be aware of exclusion criteria for 1. Surgery at HC 2. Weekend surgery. 3. Same day discharge after arthroplasty 4. Spine surgery. All of the these have been posted on our wiki site as well as in the folder in the Anesthesia office

• In you cancel a case, please email the MRP (don’t delegate this) - cc nursing team (see above) and the Anesthesia NP. If a case gets postponed only (not cancelled) - the nursing team leader will inform the MRP 

• GIM consults  (Dr’s Bill Cass and Quansah) are seeing selected patients arthroplasty (hip, knee) patients in consult based on criteria they created. Please change the designation on Connexal if they meet above criteria. If you would like GIM to see any other patient is consult, please indicate this on the front sheet.

• Lab/EKG orders: The MRP order a battery of labs, EKG and G&S ONLY for arthroplasty (hip, knee) patients. Anes (MD or NP) order labs/EKG for all other cases as per Choosing Wisely.

  • Anes and Medicine do review (and sign) all abnormal EKG/labs 

  • If you order a CBC to be done on admission; results take at minimum of 2h!

• Results of outside consults/labs etc

  • Discuss with NP who will be responsible for reviews of reports (consults, lab results, EKG)

  • Please look at Connecting Ontario 1st  - if not available ask PAC clerks to obtain.

  • Complete pre-admission orderset:

    • Order premedications for all patients (also those consulted on zoom) – acetaminophen, Celebrex +/- others

    • Order monitored or SCU beds (as per OSA protocol) on pre-admission order set.

    • SCU bed request / order:  this list is not exclusive; use your own judgment.

• Pharmacy tech phone patients ahead of surgery to obtain list of current medications.

• Patient education. Excellent resources (in paper and electronic) has been developed in house. Please refer patients to sections on choice of anesthesia and pain management.

• Please discuss home catheters with eligible patients. Strongly recommended for ambulatory TSA and rotator cuff repairs.

• Billing issues:

  • Print Holland APS list on arrival and bill APS visits for the day you are in clinic  

  • All clinic billing done manually (note that Holland PAC does not use TrackPAC)

  • Patients seen by NP needs to have NP note co-signed on iPro or make an extra note on Sunnycare.