PACE Clinic

Preoperative Assessment Clearance Education

If you are scheduled for an orthopedic surgery at Dupont Hospital, you will likely be seen in the Preoperative Assessment Clearance Education Clinic. The PACE Clinic was developed to help ensure complications after surgery are minimized or eliminated for all orthopedic patients. Research has shown that many complications can be prevented if patients are better evaluated prior to surgery.

Another goal of the PACE Clinic is to educate patients about their surgeries to help ensure the overall surgical experience is positive. The more patients know about the before, during and after aspects of their surgeries, the less anxiety they feel and the better their outcomes. The preoperative evaluation process is designed to provide the information patients need to feel comfortable with the entire surgical experience.

During the PACE Clinic appointment, a healthcare provider will:

  • Take a medical history.
  • Perform a physical exam.
  • Review pertinent tests ordered by the preop physician.
  • Discuss which medications should or should not be taken before and immediately after surgery.
  • Order additional tests that may be necessary before proceeding with surgery. Lab tests can be performed the same day as the PACE Clinic appointment, but specialty tests, such as stress tests, sleep studies or echocardiograms, will need to be scheduled. Clinic staff will schedule additional testing to minimize surgery delays.
  • Coordinate surgery plans with the surgeon, anesthesiologist and primary care physician.
  • Ensure physical and occupational therapists prepare patients for surgery, assist with exercise and walking programs and teach patients how to use special equipment, including crutches, walkers and raised toilet, if needed, after surgery.

Please bring the following to your appointment:

  • An updated list of all medications, including the medication name, dose in milligrams and when the medication is taken
  • Name and phone number of your primary care physician and any other specialists
  • A list of any other hospitals at which evaluations for heart or lung disease or stroke were performed

The Education Process
As soon as patients know they need orthopedic surgery, the education process begins. Information covered includes:

  • What to expect before, during and after surgery, in the hospital and at home
  • What to expect upon arrival at the hospital
  • How pain is managed
  • Types of bandages, drains and/or tubes that will be used
  • What to expect from physical and occupational therapists
  • What home equipment is needed and how to use it
  • Joint Camp, where patients meet the anesthesiologist, pharmacist, physical and occupational therapists, nurses and other care-team members to discuss individual care plans

The Preop Evaluation
Some patients are unaware they have a medical condition. For this reason, the PACE team
evaluates each patient prior to surgery and participates in the development of a treatment plan designed to help minimizes risks. This thorough process is in addition evaluations performed by the primary care physician. Unless an underlying problem is identified, the information gathered by the PACE team will be all that is needed, and the surgery can proceed as scheduled. If a referral to a specialist is needed, clinic staff will schedule the appointment. Additional medications can be prescribed by the clinic's physician or nurse practitioner in coordination with the primary care physician.

The preop evaluation process includes:

  • Complete review of each patient's unique medical issues and potential medical and surgical risks, as well as all test and consult results.
  • A visit with the PACE physician if a medical or surgical risk is identified.