Rutledge Tower Anesthesia Preoperative Assessment Clinic

Hours of Operation
8 a.m. to 5 p.m., Monday through Friday. Patients require an appointment to be seen in clinic.

Location
The Preoperative Assessment Clinic is located on the 4th floor of Rutledge Tower (use Elevator A, which opens directly into the waiting area for the clinic).

Contact Information
The main number is 843-876-0116

Purpose
MUSC’s Preoperative Assessment Clinic is part of a collaborative effort between the MUSC Department of Anesthesiology, Division of Hospital Medicine and the hospital administration to:

• Improve operating room (OR) efficiency.
• Identify potential complications related to anesthesia or surgery.
• Perform surgical risk assessment.
• Inform patients about what to expect on the day of their procedure.

Information for Patients
The MUSC Department of Anesthesiology and Perioperative Medicine administers approximately 3,000 anesthetics per month. Anesthesia services are provided in multiple locations throughout the hospital including traditional operating rooms, interventional radiology sites, cardiology procedure suites, and the Digestive Disease Center. The Preoperative Assessment Clinic provides multiple services for patients scheduled to undergo surgery including hospital pre-registration, nursing assessment, anesthesiologist and hospitalist evaluation, blood and urine testing, and patient education.

For Surgery Clinics

Once it is determined that a patient requires surgery, he or she may be given an appointment for evaluation in the Preoperative Assessment Clinic.  Any patient with significant cardiac or pulmonary comorbidities (i.e. pacemaker/ICD, CAD, MI, CHF, COPD, oxygen dependence, pulmonary hypertension, valvular heart disease, arrhythmia , etc) should be sent to clinic for evaluation.  It greatly facilitates the flow of information through our electronic systems when cases are posted in Epic prior to the patient’s clinic appointment.  In addition, surgical risk assessment is facilitated by a clear understanding of the operative plan.  Ideally, patients should be given appointments in clinic two weeks or more prior to their surgical date to allow time for medical record gathering and any further testing that may be needed.

To facilitate gathering of medical records, any patient with past medical conditions treated at an outside hospital or clinic should have a Medical Records Release Form (PDF) signed at the time of his or her surgery clinic visit and scanned into Epic.  When patients bring physical records from outside hospitals, please be sure to scan relevant cardiac and pulmonary testing reports (i.e. heart cath reports, stress tests, ECHOs, PFTs, etc.) into Epic.

The Preoperative Assessment Clinic uses a combination of surgical risk classification as well as patient-specific comorbidities to determine appropriate laboratory testing needed prior to patient arrival in the OR. Please refer to the Surgical Risk Classification System (PDF) to determine if a given surgical case falls into the low, moderate, or high risk category. Once the appropriate category has been determined, one may refer to the following algorithms to determine what testing should be ordered:

• Low Risk (PDF)
• Moderate Risk (PDF)
• High Risk (PDF)

Should further testing or treatment be required prior to surgery, the Preoperative Assessment Clinic staff will communicate this to the primary team and assist with scheduling when able.

Chart Reviews

Patients who are not scheduled for an appointment in the Preoperative Assessment Clinic prior to surgery will undergo chart review by a clinic nurse using the information readily available in Epic.  Therefore, it is important that medical history is documented completely in the surgical clinic note.  Phone screens are reserved for patients with complicated comorbidities who find it impossible to come to the clinic due to extenuating circumstances.

Inpatients

Inpatients or patients who will be admitted prior to their procedure are not evaluated in the Pre-Operative Clinic. Once the patient has been admitted, you may contact the Department of Anesthesiology and Perioperative Medicine at 843-792-2322 to arrange to have the patient evaluated by an anesthesia provider in the hospital.

Kathryn Bridges, M.D., FASA
Medical Director