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Flow Chart Illustrating the Patient Pathway for Elective In-Patient

and Day Surgical Orthopaedic Patients

from G.P referral to the Peri-- operative Assessment Clinic

G.P Referral to Orthopaedic Consultant

OPD Private Rooms

Booking Form completed
Consent Process commenced
Hospital Information Booklet given
Relevant Patient Information given to patient and patient signs in chart receipt of same

Booking Forms sent to Admissions Department

Local Anaesthetic Booking Forms with date of surgery are sent to the Orthopaedic Day Surgical Unit (ODSU)
where they are reviewed by the ODSU nurse in charge and the ODSU secretary arranges for the date of surgery to be
sent to the patient

Booking Forms (regional, spinal and G.A. only) with date of surgery are sent to the PAC

All in- patients are reviewed in the PAC

The Peri-operative Nurse will review Day Surgery Booking Forms (regional, spinal and G.A. only) and make a
decision based on the patients past medical history if they require either a visit to the PAC for pre- admission
assessment or pre- admission assessment via telephone by a PAC nurse

PAC appointment date (at least 6 weeks prior to date of surgery), date of surgery and
PAC Patient Information Leaflet are posted to each patient

In the PAC the patient is reviewed by the following professionals:
2 The Peri- operative Nurse reviews all patients. The PAC nurse will refer patients to Dieticians, Speech and
Language therapists, Social Workers and Discharge Co-ordinators as required
3 The Anaesthetist reviews unstable A.S.A 2 patients and all A.S.A.3 & 4 patients
4 The Physiotherapist reviews patients scheduled for hip, knee and shoulder surgery
5 The Occupational Therapist reviews patients scheduled for hip and knee surgery
6 The Pharmacist reviews patients taking prescribed medications
7 The Infection Prevention and Control Officer reviews all patients who are MRSA positive and who have a
history of MRSA

In the PAC, blood, MRSA screening and E.C.G results are managed as follows:
8 Abnormal results are reviewed and signed by a medial person. Prescription written if MRSA positive.
9 Normal results are reviewed and signed by a designated PAC nurse competent in analysing these results
10 Some results may necessitate the patient returning to the care of their G.P. This will be decided and organised
by either the Anaesthetist or the Medical Person (Project Team) in the PAC.

All x-ray results are reviewed by a medical person

In the PAC, Group and Screen is undertaken by a PAC designated nurse competent in venepuncture and is managed as
11 Patients scheduled for surgery on Mondays and Tuesdays return to the PAC on the Friday prior to surgery
12 Patients scheduled for surgery on Wednesdays, Thursdays and Fridays return to the PAC on the Monday
prior to surgery (Tuesdays on Bank Holiday weeks)

Following pre-admission assessment the patients Booking Forms are returned to the Admissions Department and all
other documentation is sent to the Medical Records Department

A database of patients’ medical record numbers, contact details and interventions is kept at the PAC