***REQUIRED READING!***
PLEASE READ THESE PREOPERATIVE INSTRUCTIONS
AND THE PATIENTS RIGHTS DISCLOSURE BEFORE
COMPLETING THE PATIENT QUESTIONNAIRE!
You may also download a pdf version of this document here.
THE DAY BEFORE SURGERY:
Smokers should not smoke for 24 - 48 hours prior to surgery to enhance breathing.
If you take daily medication, check with our pre-op nurse or your surgeon about the medications you should or should not take prior to your surgical procedure.
In order to avoid canceling your surgical procedure we ask that you:
Do not eat or drink anything after midnight, including water, chewing gum, chewing tobacco, mints, or hard candy.(For afternoon surgeries after 1:00 p.m. you may eat and drink clear liquids up to eight hours (8 hrs) prior to your check in time.)
Infants may have formula or milk up to 6 hrs before check in. They may have breast milk up to 4 hours before check in.
THE DAY OF SURGERY:
Please report to The Center for Special Surgery one and one-half hour (1.5 hrs) prior to your scheduled surgery.
If you are having a pain management procedure please report to the surgery center one hour (1 hr) prior to your scheduled procedure time.
To help reduce the possibility of infection we ask that you bathe or shower with an anti-bacterial soap prior to your arrival.
Wear clothing that is easy to take off and put on. If you are having shoulder surgery please wear a very large front- buttoned shirt. If you are having knee/hip surgery please bring shorts, or very, very large wide legged pants/sweat pants. If you are having any type of abdominal surgery please wear very loose and comfortable clothing with non-restricted waistband.
If you have any signs of an infection, fever, skin rash, cold, or sore throat notify your surgeon prior to coming to surgery center.
Leave all your valuables, jewelry, and body piercings at home.
PLEASE bring your photo ID., insurance card, and any co-pay / deductible that applies.
If you wear contacts, bring a storage case and solution for them.
If you wear glasses or hearing aids, bring a case to store them in while you are in surgery.
If you wear dentures or have removable bridgework they may be removed before surgery.
AFTER SURGERY:
After leaving the operating room you will be taken to the Post Anesthesia Care Unit (PACU). Here you will be cared for by all RNs. Due to federal laws regarding HIPPA (Health Information Privacy Protection Act) please inform your family that they will not see you after surgery until you are ready to be discharged.
You will be asked to assess your pain levels on a scale of 0 - 10. Zero will be no pain, five will be tolerable pain, and ten will be the worst pain you can imagine. This scale will assist us in managing your post-operative pain.
Please keep in mind that this is an outpatient facility and as a patient you will be having a shorter stay so you may feel rushed. Your anesthetic is shorter acting than those used in an inpatient facility, however, it still can induce amnesia. Please inform your family that this will be temporary. You may be very sleepy when you are discharged home. This is why a responsible adult needs to drive you home and stay with you for the first twenty-four (24 hrs). Your discharge instructions will be given to the person you have named as your responsible party.
SPECIAL TIPS:
Admission to a hospital may be a possibility if your physician so decides.
If there is a possibility of you being pregnant, please notify your surgeon.
Please have no more than two adults accompanying you.
We share parking with the Texas Center for Athletes - fees are $1.00/hr, max $4.00 per day.
Children must have parent or legal guardian that remains in the surgery center until the child is discharged. You may bring their favorite toy or blanket.
PATIENT RIGHTS AND RESPONSIBLITIES:
You have the right…
To have The Center for Special Surgery @ TCA respond to your requests and needs for treatment or service provided that the space is available, and to receive the care that reflects your interests and that has been determined by your physician, and respects your advance directives or your rights to formulate advance directives.
2. To be informed of the right to care that is respectful, recognizes dignity and is private to the extent possible.
3. To have patient information treated confidentially, based on applicable laws and regulations.
4. To be involved in making decisions regarding your care, including assessment and management of pain.
5. To be given information in the language you understand or to have information interpreted.
6. To give informed consent, that is, to make decisions in collaboration with your physician that involve your health care. Consent may be given by the patient or the patient’s legal representative. In order to give consent, the patient will be provided information to include:
A. An explanation of recommended treatments or procedures in terms that are understandable.
B. An explanation of the risks and benefits of treatment, including the chance of success, mortality risk and serious side-effects.
C. An explanation of the alternatives and the risks and benefits of such.
D. An explanation of the likely consequences if no treatment is pursued.
E. An explanation of the recuperative period, including anticipated problems and anticipated length of recuperation.
F. An explanation that the patient or his/her legal representative is free to withdraw consent and discontinue participation in treatment.
G. A disclosure statement that the patient’s physician is participating in teaching, research, experimental or education projects relating to the patient’s case.
7. To an explanation of admission procedures, which shall include disclosure upon admission, of the facility’s policy statement on patient rights, which shall include:
A. The right to participate in all decisions involving care or treatment, consistent with state and federal statutes.
B. The right to refuse any drug, test, treatment, procedure or treatment consistent with the state and federal statutes, including likely medical consequences of such refusal.
C. The right to receive considerate and respectful care in a clean and safe environment, free of unnecessary restraint.
D. The right to be informed of the facility’s rules and regulations applicable to the patient.
E. The right to be informed of the facility’s grievance procedure. The Administrator may be reached by calling 858-7066.
8. To know name, professional status and experience of the staff providing care or treatment.
9. To be informed prior to the initiation of general billing procedures.
A. Prior to the initiation of non-emergency treatment, upon request, the patient has the right to be informed of routine, usual and customary charges or estimated charges for service based on an average patient with diagnosis similar to the tentative admission diagnosis of the patient.
B. If you have questions, please call 858-7083 for medical cost information between the hours of 8:00 a.m. and 5:00 p.m. on weekdays.
C. Based upon insurance information provided by the patient, the facility shall provide assistance as needed with estimates of co-payments, deductibles or other charges that must be paid by the patient. Such assistance may be obtained weekdays between 8:00 a.m. and 5:00 p.m. by calling the facility business office manager.
D. The facility may include a disclaimer with the disclosure of any charges. Such disclaimer may include further variables, which may alter any disclosed charge. Any charges prohibited by law or third party payor contract will include a no charge disclaimer in the disclosure.
10. To be provided with information regarding teaching, research, educational or experimental projects related to your care. You have the right to refuse to participate in such projects.
11. To have your medical records maintained in confidence and in accordance with the medical staff bylaws, rules and regulations. You have the right to have access to your medical record by contacting the facility at 858-7063.
*Texas Department of State Health Services
Facility Licensing Group – (888) 973-0022
**Accreditation Association for Ambulatory Health Care
(847) 853-6060
*** Medicare Beneficiary Ombudsman - http://www.cms.hhs.gov/center/ombudsman.asp
You have the responsibility…
To provide the facility with accurate and complete information about your present complaints and your past health history.
To be considerate of other patients, physicians and facility personnel. To show respect for the belongings of others and facility property.
To discuss your health problems with only those involved in your care.
To request your records through the facility.
To inquire as to the name and purpose of any personnel caring for you.
To say whether or not you understand a contemplated course of treatment and your obligations in the administration of the treatment.
To cooperate with any research or experimental project in which you consent to participate.
To inform the staff that translation is required.
To provide the facility with the necessary information for insurance processing and to be prompt in payment of facility bills.
To be cooperative during recommended treatment.
PHYSICIANS OWNERSHIP DISCLOSURE:
The partners listed below make up the partnership of The Center for Special Surgery. An interest in this facility enables them to have a voice in the Administration and Medical Policy of this health care institution. This involvement helps to ensure the finest quality surgical care for their patients.
Dr. Marque Allen
Dr. Ralph “Bud” Curtis
Dr. Ellen Lin
Dr. Jaime R. Garza
Dr. David P. Green
Dr. John Ingari
Dr. Karen Johnston Jones
Dr. Susan M. King
Dr. William C. Pederson
Dr. Brian Perry
Dr. Stace’ Rust
Dr. David Schmidt
Dr. Steven Schuleman
Dr. Richard Steffen
Dr. Charles A. Syms
Some of the physicians also perform surgery at other surgical facilities in Bexar County. If you have a preference of where your ambulatory procedure is performed, please let us know. Special emphasis is place on patient feedback so that we can treat you professionally and courteously at all times.
ADVANCE DIRECTIVES:
The presence of an Advance Directive in a medical record indicates the patient’s preference for continued medical care and should be noted. In order to determine if a patient has a Living Will or Advance Directive, the patient is questioned during the admission process. The Surgery Center will not honor do not resuscitate orders of an advance directive. The parent (s) or guardian (s) of a minor child will at all times be included in the decision-making process regarding the course of treatment for the patient In the event of a patient transfer or transfer of medical records from this facility to another, The Advance Directive should be part of the record sent.
The two most common forms of advance directives are the Texas Directive to Physicians and the Texas Medical Power of Attorney.
Texas Directive to Physicians and Family or Surrogates (formerly called Living Will): a written statement of wishes regarding the use, withholding or withdrawal of life-prolonging treatment, nutrition and hydration if a person has a terminal condition and is incapable of making decisions for himself at that time. The directive can prohibit OR authorize the use of life-prolonging treatments when a person's condition is terminal or irreversible. For example, the document may state that the signer's life should not be artificially prolonged by extraordinary measures when there is no reasonable expectation of recovery from extreme physical or mental disability. However, the document can request that every effort be made to prolong life by extraordinary measures. Under "additional requests," the individual can add personal instructions, such as "I want to receive as much pain medication as necessary to ensure my comfort," or "I do not want a food tube inserted." Generally, this directive only goes into effect if the person is no longer able to make his own decisions.
Texas Medical Power of Attorney (formerly called durable power of attorney for healthcare): allows the individual (principal) to assign someone (agent) to make decisions about his medical care in the event that he becomes incapable of making informed decisions. It also allows the principal to provide the agent, family members and healthcare providers with written instructions regarding the kind of treatments that should or should not be given. Even with the Medical Power of Attorney in place, the individual will continue to make his own medical decisions as long as he is capable of doing so and can communicate those decisions. The agent's authority starts only when the attending physician certifies in writing that the individual no longer has the capacity to make those decisions. Further, a power of attorney can be changed or revoked at any time and does not give the agent authority to override the decision-making of the principal.
Copies of the Texas Advance Directive forms will be made available upon request from the surgery center.
I am a patient whom is scheduled to undergo a surgical procedure at The Center for Special Surgery @ TCA. By proceeding to the questionnaire I am confirming that I have reviewed the information in this document regarding: Physician Ownership, Patient Rights and Responsibilities and Advance Directives.
Proceed to questionnaire
For further information or instructions your may contact the pre-op nurses @ (210) 614-0187, or you may leave a voice mail with a number where you can be contacted.