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Communication and Education: A Patient’s Guide to Outpatient Procedures

July 31, 2023

Scheduling, planning and preparing for a surgical procedure can be nerve-wracking and intimidating. That’s true of simple procedures, like a child getting their tonsils out, as well as more complex surgeries like a total joint replacement. By the time a patient is referred for a surgery, there’s already been a long history of appointments. But once a doctor is ready to schedule, the surgical procedure process has officially begun.

At Mississippi Valley Surgery Center (MVSC), the area’s largest outpatient surgery center, there’s a compassionate care team behind the scenes guiding patients through the next part of the process – from initial communications and insurance to educating loved ones and caregivers about supporting patients after surgery.

“There are a lot of us behind the scenes making this world go around,” said Celia Gosa, registration coordinator at MVSC. “I work with a wonderful group of people who take great care giving our patients a seamless process and good outcome.”

Step 1: Opting into text messaging

A good outcome requires patient preparation that starts with the first contact between a doctor’s office and the Surgery Center. MVSC prides itself on providing a convenient and patient-centered facility for outpatient surgical services – performing approximately 9,000 procedures each year and employing close to 100 clinical and non-clinical personnel.

The non-clinical administrative team has a big responsibility handling patient communication and education. In most cases, a patient’s first contact is with a registration coordinator like Celia.

Once the patient’s paperwork is sent over from the doctor’s office, the computer system automatically connects to the MVSC text message application, sending a message to the phone number the patient provided. The first message will ask the patient to opt into the text messaging service. Patients who don’t opt in will get a traditional phone call from a coordinator. Patients who do accept text messages will immediately get a follow-up text with the next steps to start registration and give health history.

“We live in a day and age of technology and a big portion of our patients communicate best using text messaging,” Celia said. “It’s a nice tool for patients, especially people who work during the day or keep different hours. This fits into everyone’s schedule.”

About 85% of MVSC patients opt into the text messaging system. All electronic communications are HIPPA-compliant to ensure patient confidentiality, but registration coordinators and other staff are also always available by phone for those who prefer it.

Step 2: Understanding insurance

While scheduling surgery is done between the doctor’s office and the patient, the Surgery Center’s goal is to make sure all the advance work is done to remain on the schedule, continuing with insurance.

When patients begin receiving electronic communications regarding their procedure, emails will also include details about their insurance benefits. Registration coordinators break down the costs, so a patient knows before their procedure what the final cost will be, how much insurance will cover and how much they’re expected to pay out of pocket.

“Insurance is a very complex thing that is constantly evolving,” Gosa said. “It’s always rewarding when you can help somebody fully get a better understanding of where these numbers are coming from and help them decide if now is the right time to have this procedure and how to pay for it.”

Step 3: Providing health history

Once a patient decides to move forward with surgery, their health history determines whether they’re a good fit for an outpatient procedure at MVSC.

Health history nurses are responsible for compiling a comprehensive report on a patient’s health background and other factors that contribute to the patient’s health status. Patients can complete a detailed questionnaire online through the text messaging system or speak directly to a health history nurse, like Carrie Porter, over the phone.

“The goal is to prevent surgery from getting cancelled once the patient is here and ready to go,” Carrie said. “It’s rare, but it does happen if the anesthesia provider makes the call that the patient is not the right fit.”

The team of certified registered nurse anesthetists (CRNAs) reviews the patient’s materials both prior to and on the day of surgery. That’s why the pre-screening by nurses like Carrie is so crucial. Additional lab testing or consultation may be necessary prior to surgery, or doctors can’t move forward.

“For example, a female of childbearing age may need a pregnancy test,” explained Carrie. “A diabetic patient may need additional labs. We may need notes from a patient’s cardiologist or other specialist they may see. We need to follow up on all those things to ensure the health and safety of our patients.”

Step 4: Pre-operation preparation

Just as the surgical team needs to prepare, good information ensures a patient is ready for the day of surgery and the recovery to follow. MVSC pre- and post-op nurses like Christi Webster are there to teach patients and their caregivers what to expect after the procedure and provide home care instructions. Patients will also get information about medications and supplies to buy ahead of time and what to wear on the day of the procedure.

“This is one of our most important roles, because it makes the patient feel confident going home,” Christi said. “I get a lot of satisfaction when patients are happy as they’re leaving the Surgery Center. They’re confident that they know what’s going on and what they should be doing next.”

Patients and their caregivers may also ask questions about what’s normal after surgery – from pain levels to post-operative bleeding. Good preparation also helps patients communicate with their employers about when they can go back to work and at what productivity levels.

Step 5: Recovery and discharge after surgery

After a successful outpatient procedure, there are two phases of recovery. In the 15-30 minutes after surgery, the patient will work one-on-one with a nurse to get any pain and nausea under control. During this time, the doctor will also meet directly with a patient’s loved ones to offer them an update.

Once the patient returns to their room for recovery, the nurses will go back over the discharge instructions and answer any additional questions. For most patients, discharge is the last interaction the patient will have with the Surgery Center team, and the patient will resume their care in their provider’s office.

From start to finish, the Mississippi Valley Surgery Center team takes pride in its commitment to high-quality health care and high standards. MVSC is Iowa’s only AAAHC Advanced Orthopaedic and Spine Certified surgery center, requiring the staff to participate in ongoing self-evaluation, peer review and education. Building relationships and trust between patients and the staff gives everyone on the MVSC team satisfaction at the end of the day.

“A successful day for me means I got in touch with all of my patients,” Carrie said. “Everybody completed their labs and EKGs, all of their documents were on the charts and all my patients had surgery as scheduled.”


Common outpatient Q & A’s

Who’s a good candidate for outpatient surgery?

  • Must be at least 3 months old
  • Body Mass Index (BMI) less than 50
  • No history of heart attack or stroke in the last 6 months
  • No stent placements in the last 6 months

How many bills can I expect to receive?

You may receive up to five (5) bills for your procedure. Typically, those bills will come from the following sources:

  • Doctor’s Fee – billed by your provider
  • Facility Fee – billed by Mississippi Valley Surgery Center
  • Biopsy Fee – billed by the pathologist that reviews your biopsy, if applicable
  • Lab Fee – includes healthy history pre-testing completed prior to surgery
  • Anesthesia Fee – billed by the anesthesia provider

How much preparation is needed for a total joint replacement procedure?

It typically takes one month of preparation to get a patient ready for a total joint replacement. At MVSC, nurse navigators work one-on-one with patients to finalize the details and complete pre-op testing and health history. Total joint patients will have extra pre-op protocols and likely need to purchase additional medical equipment to support their recovery.

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