Centers & Services

PERIO Perioperative Management Team

The Perioperative Management Center (PERIO) was organized in September 2008, first in Japan, to provide comfortable, safe, and secure environments efficiently for surgery and the perioperative period (from preoperative outpatient to after surgery) to patients who undergo surgery at Okayama University Hospital. The Center is designated as “PERIOD” in the hospital.
Perioperative Management Center can enhance the therapeutic effects of surgery by a multidisciplinary collaboration team by undertaking efficient and effective preoperative evaluation, preoperative education, perioperative management, and postoperative pain control in a consistent way from the time of the outpatient visit. Members who support the team include anesthesiologists and surgeons as leaders, with collaboration by dentists, nurses, pharmacists, physical therapists, registered dietitians, dental hygienists, dental technicians, and clinical engineers.

Description of Activities

[Efficient Preoperative Physical Evaluation]

Nurses undertake interviews and physical examinations based on checklists and check data. Pharmacists check patients’ own medicines brought into the hospital. At the Department of Dentistry, checking in the mouth and total removal of dental plaque are performed before surgery. Protectors are made as needed. We improve the safety using a double check system by which final checks are made by anesthesiologists in charge of the management of patients during surgery.

[Enhancement of Preoperative Preparation]

We prepare patients mentally by informing them about many aspects of surgery, enabling them to form a mental picture. Additionally, we tell them how the surgery can be expected to affect their life, with the intention that patients undergo surgery with full understanding. Each professional provides detailed explanations about preparations that patients themselves deal with to prevent complications with surgery (e.g., breathing exercise by physical therapists, nutritional guidance by registered dietitians, and tooth brushing guidance by dental hygienists). In this manner, we work hard for patients to undergo surgery in good conditions both psychologically and physically and enhance recovery after surgery.

[Safe Perioperative Management]

With regard to management during surgery, “nurses for perioperative management” who belong to the Division of Surgery received certain training, and were certified by the hospital undertake the management of patients who undergo surgery, in collaboration with anesthesiologists. This management leads not only to increased safety in monitoring and medication during surgery, but also to the efficient management of operation rooms. Seven nurses for perioperative management, including trainees, are active at the moment.

[High-quality Postoperative Pain Control]

We explain the harmful effects of pain at the time of perioperative outpatient visits for patients to complain about pain without hesitation. We also explain a method by which patients can inject medicine for pain relief by themselves (patient controlled analgesia or PCA) to undergo surgery with ease. Furthermore, by standardizing systems for postoperative pain control, such as pain assessment and analgesic use including side effects, in the hospital, we make efforts for patients to be able to spend time as comfortably as possible. After surgery, we collaborate with ward nurses and make referrals to pain centers as necessary.

Features

The Perioperative Management Center, which started its operation in 2008, has performed interventions in respiratory surgery, esophagus surgery, laryngectomy surgery at Head and Neck Cancer Center, gynecological abdominal surgery, and breast endocrine surgery by March 2014. It deals only with limited surgery, but has achieved outcomes such as reduction of last-minute cancellation of surgery, shorter hospital stay after surgery, and reduction of complications in each case. We would like to be able to intervene in all anesthesia cases in a prompt manner.
We aim for “patients to become members of team medicine” and to be involved in surgery on their own initiative.