Hospitalist Holly Ray, MD has taken on the role of Medical Director at the “Surgery Navigation Center” at New Hanover Regional Medical Center (“NHRMC”) in Wilmington, NC. According to an article in the Star Line News, the center opened in October 2018 with the goals of providing a single-entry point and filtering about 40,000 patients undergoing procedures. The Center uses an algorithm based on patients’ surgical procedure and medical complexity to provide the appropriate level of preoperative evaluation and preparation. They see preoperative patients for a number of hospitals and ASC’s in the Health System. Having a standardized optimization protocol helps NHRMC avoid same-day cancellations for patients, readmissions and the risk of post-operative complications.
Although the strategy for pre-op preparation utilized in the “Surgery Navigation Center” is in place in many facilities, some health systems struggle to utilize a centralized PAT center. In an environment where margins are constantly under pressure, creating economies of scale where possible should be a goal of every system. A single location can maximize the efficiency of nursing, and physician personnel. Incorporating centralized phone screening mechanism can also minimize the number of patients who need to travel to the testing center.
Another item to note from the article is that Dr. Ray is a hospitalist. While PAT oversight is often fulfilled by anesthesia personnel, many private groups can’t allocate dedicated providers to a PAT clinic. Certainly hospitalists and other physicians can fulfill this role, but many systems would need a critical mass of patients (perhaps facilitated as in NHRMC by combining patients across the system) to justify the dedicated physician expense.