Open Forum

I support a specialty/subspecialty ambulatory cardiovascular clinic. 

Our providers perform a lot of outpatient procedures with moderate sedation (without anesthesia support). We have varying practices around the pre-procedure instructions given to the patient in our different clinics. 

I am interested to know how other clinics that support providers that perform these types of procedures provide the pre-procedure instructions to their patients.

Who provides the pre-procedure instructions to the patient?

• Is this done by clinic staff or personnel in the outpatient procedure department?
• Is this something that a medical assistant or non-clinical person is taking on? 

How are the patient specific medication holds (if needed) identified for the patients?

• Is the proceduralist, a nurse, a pharmacist, or other identifying these specifics for the patient?

Thank you, 

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Kristie Hills
Clinical Nurse Specialist
Cardiac Study Center/Pulse Heart Institute
Washington State
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I work as a health care surveyor and I have seen a number of ways different areas provide pre-procedure instructions. Many rely on the health care team to call a day or 2 before the procedure. Other sites rely on the MD office staff to provide the instructions.  I have seen a number of quality studies that support changing processes --for example if you have a high same day cancelation rate due to failure to follow instructions, then somewhere this is broken in your system.  I always caution people when they have a medical assistant or Unlicensed Assistant Personnel providing instructions if it is outside scope of practice. That always is a red flag for me. I would recommend you look at your process and see where the breakdown is or what is the weakest link and then come up with a plan involving your team to make this successful. 

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Elizabeth Anderson MSN AMB-BC
Retired
Port Ewen NY
(914) 466-8524
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Original Message:
Sent: 01-08-2026 00:31
From: Kristie Hills
Subject: Outpatient Procedure: Pre-Procedure Instructions

I support a specialty/subspecialty ambulatory cardiovascular clinic. 

Our providers perform a lot of outpatient procedures with moderate sedation (without anesthesia support). We have varying practices around the pre-procedure instructions given to the patient in our different clinics. 

I am interested to know how other clinics that support providers that perform these types of procedures provide the pre-procedure instructions to their patients.

Who provides the pre-procedure instructions to the patient?

• Is this done by clinic staff or personnel in the outpatient procedure department?
• Is this something that a medical assistant or non-clinical person is taking on? 

How are the patient specific medication holds (if needed) identified for the patients?

• Is the proceduralist, a nurse, a pharmacist, or other identifying these specifics for the patient?

Thank you, 

------------------------------
Kristie Hills
Clinical Nurse Specialist
Cardiac Study Center/Pulse Heart Institute
Washington State
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