Lecture 5.4 - Procedure Day

Know how to prepare your patients effectively, review check-in procedures, and create a personalized procedure plan during the consultation. Get insider tips on handling common challenges like low platelet counts, anxiety, and pain control, and discover innovative strategies for a better orthobiologics application.

Tune in now and make your orthobiologics procedures a benchmark for patient care!

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Transcript

Intro
Hey, I'm Dr. Ariana DeMers. I'm an orthopedic sports medicine surgeon, and I have successfully integrated orthobiologics into my busy practice so that I can provide a continuum of care and treat patients who are in the gap. The gap is this gray area in orthopedics where standard conservative treatments have not been effective, but surgery may not be warranted. And we usually tell our patients, come back when it's worse. What? These are your patients coming to you for help. Orthobiologics is that solution that can fill the gap and help you treat your patients who are in your office looking to you for help. Orthobiologics can also be an excellent treatment for frustrating problems without good surgical outcomes. This podcast will help you create the orthobiologics business that will make you love your job again. We will focus on the value of orthobiologics, patient selection, how to talk to your patients about money, office setup, and other logistics. If this is something you've always wanted but don't know where to start, join me in "The Business of Orthobiologics" podcast.
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Dr. Ariana
Hi, welcome to Procedure Day. This is so exciting. Today's the day. Today, we'll talk and guide you through your procedure day in the orthobiologics implementation process. This will ensure a smooth procedure day that is vital for patient comfort and safety. I recommend to schedule one day a week for the first month, and regardless of whether it's filled or not, please don't put anything else on this day. This will give you time to troubleshoot the process. I'm going to recommend that after each procedure, make sure you recap, troubleshoot, and then fix the issues or needs on the spot that day. Use this time to work on the business to allow for a smoother future procedure. Let's first discuss how to prepare your patients for the procedure. Make sure you review your patient check-in procedures and ensure that everything is in place. Make sure all of the necessary equipment and supplies are readily available, and then review your pre-visit education and your indoctrination materials, such as a welcome video on how your practice does things, maybe how to prepare the patients to know, like, and trust you so that they want to move forward with the recommended treatments. Next, we'll provide a step-by-step walkthrough of the orthobiologics procedure. I do recommend reviewing the How-to videos, write out a step-by-step for each patient, and then do this for the first 10 patients. It will get easier and smoother over time, and it'll become second nature. Before the blood draw, I have a procedure plan that I create with the patient during their consultation. This looks like where I'm going to inject, what I'm going to inject, what the diagnosis is, what the problem is, and all of the things that I'm going to do, including if I'm going to do any nerve blocks, any nutrition implementation. Then I use this procedure plan, as an order form for how much blood my nurse needs to draw and what type of injectates we need to create for the treatment. Then the blood is drawn, and processed, the injectates are created and labeled, and prepared for use. The injections are then set up according to a prior plan, as well as the items needed for sterility, ultrasound, pain control, bleeding, and any of those issues. So have that injection set up documented both in written form as well as picture. Next, make sure that you have proper technique and emphasize patient comfort and safety throughout this procedure. A common challenge that we may see is that you don't have enough blood. Maybe the patient has a low platelet count. Maybe they have inadequate pain control or have too much anxiety. We educate our patients to hydrate for the 1-2 days prior to the procedure. We also recommend limited use of caffeine on the day of the procedure to make sure the blood draw goes well. Ultrasound can help identify those difficult draws and can help identify veins that maybe are unable to be seen on the surface. We use music therapy as part of our relaxation protocol and occasionally we use Ativan as well. That is pretty rare, but we do use that. I use a liberal application of regional anesthetic, and it's really important to allow time for it to set up. There are vibratory tools or tapping that can also help with discomfort to interrupt those aberrant pain signals. Really, to make this a successful application of orthobiologics, patient comfort is paramount during the procedure. Make sure that they're resting comfortably, maybe an eye cover or pillow underneath the knees? Is their neck comfortable? Do they need a neck roll? Those kinds of things. Make sure you discuss the strategies for pain relief and discomfort and have clear, effective, ongoing communication with the patient. Let them know that you're not going to sneak up on them, that you're going to be discussing and giving them warning as to what they're going to be experiencing, what they're going to be-- what's going to be happening next, and come up with a strategy that works for the patient. Please also make sure that patients know that some of these procedures cannot be pain-free. This helps to manage the patient's anxiety and set clear expectations throughout the treatment. I'm going to ask for action items. I would like you guys to make sure you establish a comprehensive checklist for pre-procedure preparation and make sure you have photos with common setups. I'm going to recommend you conduct a practice run of the entire procedure with your team to ensure everything goes smoothly. You could offer this as a free procedure for friends and family or do it for one of your office employees just to make sure that you know where your blind spots might be. Next, implement strategies for patient comfort and effective communication. Make sure you keep asking them how they're doing, and how things are going. Do they need a break? Do they need improved comfort? And have ice packs or heat packs available. Make sure that you have anti-nausea. Some patients really struggle with this. And so I think that having all these things ready for the procedure will allow the patient to have a smoother experience and not be surprised if they're having a little bit of pain because they've already been educated. So you can find a procedure day checklist and step-by-step guides throughout Module 3. And really, I would say for guidelines on patient comfort and communication, consider talking with patients after the procedure to brainstorm better ways to help future patients and maybe take some recommendations from the patients as to what was hard, what was easy, what they were surprised about, what was really clear, and what might need better clarification. So exciting. Procedure Day is upon us, and good luck. Keep working hard and troubleshooting. And then be really confident that you have all of the education that you need to effectively help your patients do better.
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Outro
This has been "The Business of Orthobiologics" podcast. Thank you so much for joining us today. If you want to know more, please join us on the website, "PRP-Now.com", and click on the FREE masterclass. Also, don't forget to SUBSCRIBE to this podcast to get more guidance on integrating PRP in your busy practice. Bye for now.
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