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Holland Centre Virtual PAC Visit Via Zoom

Sent on behalf of Dr. M. van der Vyver
Anesthesia Virtual Pre-Admission Clinic Appointment Procedure

Patient Selection
The Pre-Admission Clinic (PAC) Team Leader will determine who is eligible for virtual Appointments based on the Consults criteria at the Holland Orthopaedic and Arthritic Centre Appendix I. This will be flagged to the PAC clerical team to book a virtual appointment.

Schedule Appointment
1. When scheduling the appointment the PAC clerical team will confirm that the patient is comfortable with Zoom.
a. If NOT comfortable schedule telephone visit
2. PAC clerical team will schedule a zoom appointment using the generic Holland Centre PAC zoom accounts (Appendix II) during the following times (max 2 per time slot):
a. 8-9
b. 3-4
3. PAC clerical team will email the patient using the generic email template Appendix III.

Day of the Appointment
1. Anesthesia will log into generic zoom account
2. Launch the meeting at the scheduled time
3. Complete assessment

Appendix I- Consults criteria at Holland Orthopaedic and Arthritic Centre

A. To be seen in person by Anesthesia
See in person if one or more criteria below is met

Surgical criteria:
• ALL arthroplasty cases (except elbow and ankle)
• Spine patients: more than 1x level (decompression and/or fusion)

Medical/anesthesia criteria:
• Any CVS disorder/disease (except essential hypertension)
• Any respiratory disorder/disease (except: mild asthma, URTI)
• Any renal disorder/disease
• Any neurological disorder/disease
• Any endocrine disorder/disease (except: stable hypothyroidism; diabetes not on insulin)
• Any rheumatological disorder/disease
• Any hepatic disorder (except remote history of jaundice)
• Any hematological disorder/disease (except mild anemia)
• BMI > 35
• Developmental disorders
• Prior anesthetic issues (difficult airway, family history, previous anesthetic complications)
• Known OSA or high risk of severe OSA (STOP BANG ≥ 5) AND not using CPAP
• Patient request
• Preference of PAC RN

B. Anesthesia virtual consults ONLY
(Anesthesia preference is a virtual consult using the ‘zoom’ platform; if a patient is unable to use zoom, a telephone consult will be offered)

Surgical criteria:
• Upper extremity surgery (other than shoulder replacements)
• Mid foot/ankle surgery - including ankle fusions
• Knee surgeries (except total knee arthroplasty; knee arthroscopy)
• Femoral or tibial osteotomies
• Spine: single level surgery (anterior or posterior; decompression and/or fusion)
• Absence of any of the medical conditions mentioned listed under A.
• Preference of PAC RN (patients in group C)
• Patient request (patients in group C)

C. No Anesthesia consult needed
• Carpal tunnel release
• Surgeries limited to forefoot and hand only
• Any procedure to be done under local infiltration ± IV sedation
• Knee arthroscopy

Appendix II- Zoom Logins

Account 1:

HollandCentrePAC1@sunnybrook.ca

43HCPACAn1

Account 2:

HollandCentrePAC2@sunnybrook.ca

43HCPACAn2

Appendix III- Generic Email Template
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RE: Important information about your virtual VIDEO Pre-Admission Clinic appointment on [insert date & time].

Dear [insert name]

You have been scheduled for a virtual appointment with Anesthesia prior to your surgery on [insert OR date]

Before your Visit:
  • Please read Sunnybrook’s virtual care consent & privacy information
https://sunnybrook.ca/content/?page=virtual-care-consent
On the day of your visit:
  • If you agree to participate in this video appointment, please click on :
  • If the connection is dropped, during the session, click on the above link again to return to the session. Please have your phone available so that we can contact you if needed.
Tips for success:
1. Connect 5-10 minutes before the appointment.
2. Close other programs on your device not needed for this visit.
3. A laptop is easier to position the screen angle; use it if you have one, so your hands are free.
4. You may wish to have a helper to take notes or assist with adjusting the camera angle.


Appointment Cancellation: Your scheduled appointment time is reserved just for you. If you are not able to keep the appointment, please notify us 2 business days before the appointment at (416) 967-8532.


** Please note that this email is not monitored regularly. Do not email appointment change requests or clinical questions about your surgery. If you have any questions please don’t hesitate to contact us at 416-967-8532.
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