APP - Perioperative Evaluation Clinic

In this role, Advanced Practice Providers (APPs) will receive comprehensive training to develop expertise in assessing various organ systems from a perioperative perspective. They will apply knowledge of basic physiology and pathophysiology across neurology, cardiology, pulmonology, endocrinology, gastroenterology, urology / nephrology, rheumatology, hematology, and common infectious diseases. APPs will become proficient in managing perioperative medication adjustments, including the holding or bridging of high-risk medications such as blood thinners, chemotherapy agents, biologics / DMARDs, steroids, and insulins.

Additionally, APPs will order and interpret advanced cardiopulmonary diagnostics, including cardiac stress tests, carotid ultrasounds, echocardiograms, and pulmonary function tests (PFTs). They will gain skills in EKG interpretation and the management of preoperative abnormal lab results. The role involves extensive care coordination, including appropriate referrals to primary care providers or specialists for further evaluation as needed. APPs will communicate effectively with patients' other healthcare providers to ensure seamless care.

Training will also cover the management of implanted electronic devices (such as cardiac devices and other implants) during surgery, including collaboration with device representatives when necessary. APPs will learn to evaluate and manage preoperative anemia, coordinating care with gastroenterology and hematology specialists as well as administering IV iron when appropriate. They will also master problem-oriented charting in EPIC, utilizing shared smart phrases and dot phrases for efficient documentation.

While prior anesthesia-specific knowledge is not required, it is preferred. This includes understanding various anesthetic methods (general, regional, nerve blocks, MAC), typical patient positioning, expected blood loss, degrees of physiological stress during different types of surgery, contraindications for anesthesia, and perioperative fasting guidelines.