1. Anesthesia consult (C visit): an anesthesia attending will see the patient.
- ASA 3 or 4 patients – chronic, unstable illness, medically complex given co-morbidities; poor functional status
(needs better risk stratification); prior difficulties with anesthesia. - High procedure-related risk/complex surgery.
2. NP/PA H&P only (B visit): seen by a MA who does the intake, then a NP/PA that completes an H&P.
- ASA 1 or 2 patients – low comorbidity patients, but they need an H&P (JCAHO requirement within 30 days
of surgery), labs, etc.
3. RN visit only: RN will complete all intake questions, med rec, preop instructions; will also obtain any lab work and/or
ECG ordered by surgeon.
- No visit with NP, PA or Anesthesiologist, therefore surgeon (or primary care provider) responsible for preoperative
evaluation and surgical H&P.
4. Phone screen (A visit): not an actual visit, a phone questionnaire
that an RN does over the phone to rule out significant medical
or anesthesia-related problems.
- For low risk patients with straight forward surgeries.
- An anesthesiologist will review pts chart and make sure there
isn’t glaring red flags that would cause a delay or cancellation
on day of surgery. - No visit with NP, PA or Anesthesiologist, therefore surgeon
(or primary care provider) responsible for preoperative
evaluation and surgical H&P.
** If in doubt of which kind of visit is necessary, please select
Anesthesia Consult (C visit).
Please use this as a simplified guide as to which type of CPC Visit is appropriate for the type of surgery being performed
and the complexity of the patient:
- The CPC process matches clinical resources and needs by means of the following an algorithm that incorporates
estimates of both patient comorbidity and procedure-specific risk. - These variables are combined into a “risk grid” that forms the basis of the three levels of a CPC visit so that the
preoperative process can meet the needs of each patient. - The surgeon can select any level of visit for the patient, but this table may serve as a guide to help delineate what may
be the most appropriate for the given surgical procedure.
