Exceptional Care: A Case Study, Part 7, Preoperative Details

By | May 12, 2011

I informed Jane that being able to proceed with the implantation was dependent on a whole laundry list of lab tests, orders and appointments. I called in Melissa, our nurse, who swabbed Jane’s nose to test for MRSA (methicillin resistant staphylococcus aureus, a type of antibiotic resistant bacteria which is becoming more and more common even in the community). If this test were positive it would potentially change her preoperative antibiotics. Melissa explained that Jane needed to get a complete set of preoperative lab tests, including a CBC, chemistry panel, PT, PTT, platelet function studies, EKG and a chest X Ray. We told Jane that she also needed to get preoperative psychological clearance (a Medicare requirement). Unfortunately, Dr. Richard Rogal, the psychologist who works with us at Schlesinger Pain Centers had just left the office. We asked Jane if it would be possible for her to go and see him in his office in Beverly Hills. At this point Jane was beginning to look overwhelmed again, so we told her that we would call Ina, Dr. Rogal’s wife and practice manager to see if Richard might be able to do us a favor and see Jane in the Valley on Monday. I explained that Ina presents the image of a tough New Yorker, but inside I think that she’s just as much of a softie as Richard is. Jane seemed a little calmer.

Melissa and I also had to call Bill Stuart at Hartley Pharmaceutical again in order to insure that the medicine that we would need to fill her new pump would be at the surgery center by Tuesday morning. In the past when we were trying to expedite the care of cancer patients Laverne, the Clinical Manager of the Glendale Adventist Medical Center Ambulatory Surgery Center, who luckily lives in Long Beach, would actually pick up the medicine directly from Hartley and hand carry it in. Laverne’s dedication to her patients is one of the many reasons that we use Glendale Adventist as our exclusive implanting site. Still, Laverne is a busy woman and we try not to take advantage of her. Again we were lucky, because Bill Stuart had fixed the bug in his phone system and we got him on the first ring. I had already explained to Bill how we were working with Laverne’s people in Glendale to push the envelope and decrease the time to implant interval and thereby cut down on the amount of needless suffering that these patients endure. With his usual “can-do” attitude Bill said that he would personally talk to Rose over at the ASC to make sure all the paper work went smoothly (this is obviously a highly regulated industry), expedite the preparation of the mixture and insure that the syringe of medication left the pharmacy that afternoon for a Monday morning delivery in Glendale.

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