At ELM, the ASC Pre-Admission Testing (PAT) Registered Nurse is responsible for the comprehensive pre-operative assessment, patient education, risk factor review, and clearance coordination of patients scheduled for procedures at Legacy Center for Spinal Surgery. This is accomplished through the collection and verification of patient information, medical records, medication history, provider orders, clearance requests, and diagnostic imaging or testing. Additionally, the PAT nurse communicates with the patient, provider, scheduling team, ASC staff, and other interdisciplinary members to ensure every patient is medically optimized, appropriately worked up, and safe for an ambulatory surgery setting. This role reports to the ASC Director.
Essential Functions:
- Conduct thorough telephonic pre-admission testing interviews, including comprehensive review of medical history, surgical history, medication reconciliation, allergies, and social history 7-10 days prior to the patientโs scheduled procedure.
- Perform and document pre-operative risk assessments (cardiac, pulmonary, airway, bleeding risk, diabetes management, obstructive sleep apnea screening) in accordance with ASC and anesthesia provider protocols.
- Apply the facility's BMI-based patient selection criteria and escalate cases outside established thresholds to the surgeon, anesthesiologist, and/or Medical Director for review.
- Initiate, track, and review required pre-operative labs, EKGs, imaging, clearances (cardiology, PCP, pulmonology, etc.), and diagnostic testing per surgeon- and procedure-specific protocols; follow up on outstanding results prior to the scheduled date of service.
- Identify and communicate anesthesia risk factors and medical comorbidities to the anesthesia team in advance of the surgery date; participate in case review huddles for complex neurosurgical patients as needed.
- Reconcile anticoagulants, antiplatelets, and other high-risk medications against surgeon and anesthesia hold parameters; provide patients with clear, written medication instructions.
- Educate patients and caregivers on pre-operative preparation (NPO status, bathing protocols, medication management) and anticipated post-operative course, including activity restrictions, wound/incision care, and pain management specific to the patientโs procedure.
- Screen for appropriate post-operative support, transportation, and discharge planning needs, including identifying candidates who may require a higher level of care than the ASC setting can support.
- Document all pre-admission testing findings, communications, and clearances accurately and in a timely manner within the electronic health record.
- Serve as a liaison between the surgeon's office, referring providers, anesthesia, and the ASC clinical team to resolve outstanding clearance issues prior to the day of surgery.
- Participate in case cancellation prevention by proactively identifying and resolving clinical and logistical barriers to surgery.
- Support compliance with CMS Conditions for Coverage, AAAHC/Joint Commission accreditation standards, and internal ASC policies related to patient selection and pre-operative clearance.
- Ensures patient procedures are accurately scheduled and coordinates with the Surgery Scheduling team, ASC Administrator, and Clinical Director to resolve and concerns relating to procedure scheduling.
- Assist patients and caregivers with pre-operative and post-operative questions, elevating concerns and needs to providers when necessary.
- Other duties as assigned.
Knowledge, Skills, and Abilities:
- Excellent clinical assessment, critical thinking, and triage skills, with the ability to identify patients who are not appropriate candidates for an ambulatory surgical setting.
- Strong verbal and written communication skills; ability to explain clinical information clearly to patients, families, and referring providers.
- High level of organization and follow-through in a fast-paced, deadline-driven scheduling environment.
- Ability to work collaboratively with surgeons, anesthesia providers, and administrative staff to resolve pre-operative clearance issues efficiently.
- Comfort with telephonic patient interviews and independent decision-making within established clinical protocols.
- Proficiency with standard office and clinical software (EHR, scheduling systems, Microsoft Office).
- Ability to understand and comply with HIPAA rules and regulations and patient Rights and Responsibilities
- Ability to use discretion and work independently under general supervision.
- Ability to understand and adhere to the Professional Code of Conduct and demonstrate professional accountability
Qualifications amp; Requirements:
- Current, unencumbered Registered Nurse (RN) license in the state of practice.
- Associate Degree in Nursing required; Bachelor of Science in Nursing (BSN) preferred.
- Minimum of two (2) years of clinical RN experience with pre-admission testing within ambulatory surgery, or a surgical specialty office required
- Neurosurgery, orthopedic spine, or pain management clinical experience strongly preferred.
- Current Basic Life Support (BLS) certification required.
- Working knowledge of pre-operative risk stratification, comorbidity management, and anesthesia clearance requirements.
- Familiarity with electronic health record (EHR) systems and ability to navigate multiple clinical documentation platforms.
- For remote roles, access to reliable internet and telephone services, specifically 10M download and 5M upload packages or higher as well as a strong WiFi signal from your remote work location.
- Must meet pre-employment requirements and maintain all applicable state and job-related guidelines for background screening. Depending on state-specific requirements, this may include drug testing, health screening, CPR/Basic First Aid, and license/credential verifications.
- COVID vaccination is required for all employees who are hired to work in an on-site setting in the ASC, and who will be working directly with our patient population, or as indicated. An exemption may be requested due to medical or religious reasons.
Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.
Physical Requirements amp; Working Conditions:
These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities; these are made on a case-by-case basis.