PACE Clinic

The P.A.C.E. Clinic at Peninsula Orthopaedic Associates gathers important medical information prior to your surgery, emphasizing anesthesia safety and promoting your ultimate surgical success. This information is utilized to ensure that you are in the best physical condition to undergo surgery. Our overall goal is to minimize your risk of developing complications as a result of orthopaedic surgery or anesthesia. Some patients may be unaware they have a medical condition and as a result, all POA surgical patients are evaluated prior to surgery. This thorough process is in addition to routine evaluations performed by your primary care provider; a copy of your P.A.C.E. Clinic office note will be sent to your primary care provider. Unless an underlying medical problem is identified, the information gathered by the P.A.C.E. team will be the only requirement to proceed with surgery as scheduled.

Peninsula Orthopaedic Associates’ P.A.C.E. Clinic stands for:

• Pre-Operative
• Assessment
• Communication
• Education

Research has shown that many pre- and post-operative complications can be prevented if patients are thoroughly evaluated prior to surgery. For most patients, the idea of surgery can be frightening. However, knowledge is power. The more patients know about what will happen before, during and after their surgery may lead to a reduction in anxiety and ultimately improve surgical outcomes. The pre-operative evaluation process is designed to provide important information that patients need to feel comfortable with the entire surgical experience.

What should I bring to my appointment at the P.A.C.E. Clinic?

• An updated list of your medications including the medication name, the dose in milligrams, the number of pills you take at a time and how often per day you take them (If you prefer, you may bring in the original medication containers).
• The name and phone number of your primary care physician and any other medical specialists that you see at least once per year.
• A list of any hospitals at which evaluations for heart disease, kidney disease, lung disease, cancer or neurologic conditions were performed.
• Sometimes, incomplete information about ongoing or prior medical problems may prevent surgery from taking place as scheduled. If you have had any medical evaluations for heart disease, kidney disease, lung disease, cancer or neurologic conditions, please bring the following documents with you to the P.A.C.E. Clinic to avoid unnecessary delays in your surgery:
  • Carotid ultrasound reports (within the last 5 years)
  • Cardiac catheterization reports (within the last 5 years)
  • Stress test results (within the last 3 years)
  • Echocardiogram (EKG/ECG) reports (within the last year)
  • Electrocardiograms (EKG/ECG) – a photocopy of the EKG tracing (within the last 3 years)
  • Pulmonary function test results (within the last 2 years)
  • Recent laboratory tests (within the last 3 months)
  • Pacemaker implantation and evaluation records (within the last year)
  • Discharge summaries from recent hospitalizations (within the last year)
• If there are any other medical records that you feel would be important for documenting major medical evaluations you have had, please bring them with you to the P.A.C.E. Clinic appointment. Since we will review your past medical and surgical history in detail, you may want to write this information down before your appointment.

You can fax your records to us at: 410-860-4512, Attention: P.A.C.E. Clinic, please call your surgical coordinator to confirm their receipt.

What can I expect during my appointment at the P.A.C.E. Clinic?

During your appointment at the P.A.C.E. Clinic, a Board Certified Nurse Practitioner will:

• Obtain your medical, surgical, social, and family history
• Perform a comprehensive physical examination
• Review pertinent diagnostic tests ordered by your surgeon
• Discuss which medications you should or should not take before and immediately after your surgery
• Order any additional tests that may be identified as necessary during the medical assessment to make sure it is safe to proceed with surgery
• Communicate with your surgeon, anesthesiologist and primary care provider about your pre-surgical health status
• If undergoing a total joint replacement or spine surgery, you will need to attend an education class at POA's Woodbrooke office, TidalHealth Peninsula Regional or TidalHealth Nanticoke depending on the location of your surgery.

Will the doctors have enough information to know if I am ready for surgery?

In most cases, if your medical records are complete and updated, your visit will provide your P.A.C.E. Clinic provider with enough information to know if you are ready for surgery. However, sometimes an underlying problem may be identified that needs to be addressed before surgery. When this occurs, arrangements will be made for more testing or consultations as necessary.

Will my surgery be delayed for any reason?

In most cases, surgery will not be delayed. However, even a simple problem like a common cold can increase your surgical risk. Other times, tests may show that an existing medical condition such as high blood pressure or poorly controlled diabetes could adversely affect your surgical outcome.

If you have a poorly-controlled medical condition (e.g. diabetes, hypertension, etc.) that requires additional treatment for medical optimization before surgery, your P.A.C.E. Clinic provider will help coordinate consultations or you may be asked to return to your primary care provider or specialist for further treatment. The P.A.C.E. Clinic will inform you, your surgeon and primary care provider about any conditions that require treatment before surgery. If additional medical optimization is required before surgery, a re-evaluation at the P.A.C.E. Clinic may be necessary for some patients.

What if my medical condition is very complicated or I am not ready for surgery?

Your P.A.C.E. Clinic information becomes part of your medical record. If your P.A.C.E. Clinic provider finds that you are not medically ready for surgery or your medical condition is very complicated, we will discuss your evaluation with your surgeon. Your surgeon can then decide whether surgery is right for you at this time.