Initiatives of the Patient Support Center

●To patients who visit the Patient Support Center (TOPS)
At TOPS, various occupations prepare patients for surgery.
Patients will be shown a video about hospitalization and anesthesia.
* You can also see it in advance on the homepage

 

 

 

 

 

Body measurements are taken by a nutritionist.

 

 

 

 

 

 

 

 

 

 

 

 

An oral check is performed by a Dental Hygienist.
It is important to clean your mouth before general anesthesia.

 

 

 

 

 

 

 

 

 

Registered Nurse will ask you questions.
Describe the flow of hospitalization and surgery.

 

 

 

 

 

 

 

 

 

 

 

Your doctor will explain how to administer anesthesia.

 

 

 

 

 

 

 

 

When necessary, nutrition guidance and allergy interviews are provided by a dietician, and drug cessation guidance is provided by a Pharmacist.

 

 

At TOPS, all the staff will help patients so that they can undergo surgery with peace of mind.

 

◎Patients scheduled to be hospitalized for examinations and treatments also receive TOPS.

• Confirmation of medicines that are usually taken
• Explanation of examination and treatment by a Registered Nurse
• If necessary, a dietician will provide nutritional guidance, an allergy interview, and a Pharmacist will provide guidance on drug suspension.

Reference materials: `` About smoking cessation'' / `` Why is it necessary to take a liver rest day before surgery'' / ``For those receiving anesthesia - Postoperative nausea'' / `` How to use the Tri-Ball (breathing training device)'' / `` Why? Is there anything I need to remove before surgery?”

Background of establishment

In Japan, the range of surgical indications for patients has expanded with the improvement of surgical techniques of doctors and the progress of medical techniques such as endoscopes and laparoscopes. At our hospital, the length of hospital stay tends to be shortened as the number of operations increases. However, the quality of patient care before and after surgery must be maintained. To provide quality patient care, healthcare professionals need to improve intraoperative and postoperative safety for surgical patients and reduce perioperative complications. Efficient quality care requires a professional team approach in perioperative management. Due to such circumstances, we have decided to open our center.

 

Purpose

​Our center opened in August 2016, with the aim of "proposing the most suitable medical environment for patients undergoing surgery at our hospital, supporting safe and secure perioperative management, and promoting postoperative recovery of patients".

The nickname of this center is "To bu Hospital P atient S upport Center "abbreviated TOPS and set up an outpatient department for surgery preparation.

Center configuration

At Patient Support Center, we support the maintenance and improvement of patients' QOL from pre-hospital to discharge through three organizations: "surgery preparation outpatient", "preoperative oral rehydration therapy team", and "postoperative pain management team".​ ​

 

 

 

Our center is composed of Doctors, Registered Nurse, Pharmacist Clinical Dietitian, Dental Hygienist, Clinical Psychologist, Biomedical Laboratory Scientist and clerical staff, and its main roles are as follows.

 

 

Registered Nurse

Registered Nurse provide preoperative care and guidance to patients undergoing surgery, minimize anxiety about surgery, and provide close-knit nursing to the patient.

■ Collecting patient information
■ Understanding the physical and mental condition
■ Assessment by multiple occupations based on information
■ Thinking about life from hospitalization to after discharge with patients
■ Providing information on hospitalized life

 

 

Pharmacist

The Pharmacist will endeavor to relieve the patient's anxiety and provide information with the following support so that the patient can undergo surgery safely and with peace of mind and have a comfortable hospitalized life after surgery.

■ Check the medicines you usually take, and check the dosage and combination.
■ Consider whether to continue, discontinue, or change the drug by the time you are hospitalized. If you need to cancel or change it, we will explain how to do it.
■ If you have any allergies or side effects caused by the drug, take measures to avoid using it during hospitalization.

 

Clinical Dietitian

A Clinical Dietitian evaluates the nutritional status before surgery and provides appropriate support so that the patient can receive a safe and secure surgery with a nutritional status suitable for surgery.

■ Pre-hospital nutrition screening, nutrition assessment
■ Body measurement (height / weight / body composition / grip strength measurement)
■ Checking the status of food intake at home
■ Confirmation of food allergies
■ Providing information on meals during hospitalization (explanation of preoperative and postoperative meals and preoperative oral rehydration therapy)
■ Nutrition counseling for patients at risk of nutritional status

 

Dental Hygienist

Oral and Maxillofacial Surgery, the following treatment and guidance are used to prevent postoperative complications (aspiration pneumonia, etc.) caused by oral bacteria and oral problems (tooth loss / fracture) during hospitalization. We carry out oral management and support safe and high-quality medical care. Oral care is provided by a dentist and Dental Hygienist.

■ Oral examination
■ Check for the presence of mobile teeth (fix teeth if necessary, make mouthguard)
■ Self-care guidance
■ Professional oral care (removal of plaque and tartar that is difficult to remove by self-care)
■ Extraction of teeth that are the source of infection
■ Oral management in collaboration with family dentistry

 

Medical assistant

Doctor office work assistants are assigned to reduce the workload of doctors. Our main duties are to input electronic medical records for doctors, prepare any documents, and check for deficiencies in preoperative examinations. In addition, we work in collaboration with various occupations according to the instructions of doctors.

■ Patient support
■ Creating a list of consultations
■ Doctor's electronic medical record proxy input
■ Issuance of consent documents
■ Preoperative examination check
■ Issuance of information medical care provision form
■ Creating an APS (Postoperative Pain Management) rounds list
■ Participation in APS rounds

 

Medical office

The medical office is in charge of the reception work at the time of consultation at the Patient Support Center.

 

Doctor

The doctor will determine the risk of surgery based on the information obtained from the staff, and will support the preparation for surgery in cooperation with the attending physician. If necessary, we will provide nutrition therapy and guidance on discontinued drugs. In addition, we will provide information from the standpoint of a doctor in response to anxiety and doubts from patients. We will share information with staff and provide support for postoperative recovery so that patients can get out of bed early and take orally after surgery.

For those who undergo surgery at our hospital

We explain the flow of hospitalization → surgery → discharge, taking as an example patients who will undergo surgery by digestive surgery such as colorectal cancer and gastric cancer surgery.

● About infection control at the Patient Support Center
TOPS has installed an air purifier (clean partition) in the examination room to prevent infection.
The rooms that are not installed are well ventilated.

 

This is the waiting room for those who are hospitalized on the day of surgery.

Surgery preparation outpatient information

We explain the actual outpatient preparation for surgery.

PostoperativePain Service team (APS)

Having APS in thehospitalallows you to spend your time after surgery with peace of mind.

1. Postoperative pain is reduced

2. Postoperative nausea is reduced

3. If it hurts or feels uncomfortable, you can respond immediately

Global studies have shown that having APS in the hospital accelerates patient recovery (moving and eating). Since our hospital has APS (commonly known as APS), postoperative pain management (pain) and nausea and vomiting (disgusting) measures are adequately implemented. On the morning of the day after surgery (excluding Saturdays, Sundays, and holidays), an APS consisting of an Anesthesiology doctor, Pharmacist, Registered Nurse and registered Clinical Dietitian will visit the patient's bedside. We will ask you about pain and nausea after surgery, and if you feel pain or discomfort, we will respond immediately. APS supports patients so that they do not feel painful and immobile, or feel uncomfortable and unable to eat.

Since the APS of our hospital is composed of the same members as the staff of the outpatient department for surgery preparation, we will fully explain the degree of postoperative pain and nausea and the countermeasures in the outpatient department for surgery preparation. It is natural for patients to have anxiety about postoperative pain and nausea, and we ask them to resolve their anxiety and doubts and proceed to surgery with peace of mind.

TOPS​APSplays the following roles in the hospital.

1. Rounds of pain and nausea in the morning after surgery

2. Initial response when pain or nausea occurs after surgery

3. Recommendations for postoperative pain management in clinical pathways

Specific pain management

At our hospital, we carry out pain management even before the patient's pain appears. Pain is relieved by epidural anesthesia and intravenous anesthesia during surgery, and analgesics are regularly administered after surgery. Analgesics mainly use acetaminophen preparations, which are said to have the fewest side effects. In addition, various painkillers are selected depending on the degree of pain of the patient. (Fig. 1)

Specific measures against nausea

At our hospital, we will ask the patient about the risk of nausea when he / she visits the outpatient department for surgery preparation. If there is a high risk of nausea after surgery, the operating room will be contacted and an Anesthesiology doctor will take measures against nausea during and after surgery. In the unlikely event of nausea after surgery, we are ready to respond immediately. (Fig. 2)

Results of our hospital

APS make it possoble to achieve DREAM,  drink (Drinking), eat (Eating),move(Mobilizing) from  the earliest time after surgery. We reported to Japan Clinical Society of Anesthesiologists magazine that pain at next morning after surgey for Gastrointestinal Surgery (stomach, colon, esophagus, pancreas, etc.) patient is one person in 10, nausea is about two person in 10, and it is very few (2017).​

We are accepting tours at any time

For applications and inquiries, please contact the Human Resources Development Support Center.
Online tours are also available.

hrd@tobu.saiseikai.or.jp