1. Your important documents and when they should be completed:

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• Service Agreement – For each hospital (signed by authorized hospital representative and returned to ACL Surgery LLC before scheduling your first surgery)

• Your Pet Owner has been guided to review their Surgery Day Expectations and has been directed to read the Resources in Pet Owner Resources to prepare themselves and their pet for surgery.

• Surgical Consent – For each patient (signed by your pet owner client and a hospital representative before admitting patient to hospital for procedure/surgery)

• Procedure Discharge Form – For each patient (reviewed and given to your pet owner client at the time of discharge by your hospital staff)

• Surgical Report – I provide this to your hospital after each procedure, and you are required to retain this for your patient documentation

• Checklists and summaries created for you convenience:

i. Abbreviated checklist for participating hospitals (this form)
ii. Attending Veterinarian Scheduling Checklist – To assist with requirements when scheduling procedures
iii. Surgery Day Checklist – To assist with requirements and flow of procedural days

2. What is everyone’s role and responsibility:

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a.  See your Service Agreement

b. ACL Surgery LLC responsibilities:

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i. Confirmation the surgical diagnosis and performance of surgical procedures.
ii. Providing procedure specific surgical instrumentation, such as orthopedic drills and implants.
iii. Immediate postoperative client communication to relay surgical findings.
iv. Issuing surgical report to your hospital, which you are required to file in the patient chart.
v. Issuing procedure specific aftercare instructions to your hospital, which your hospital is required to issue to your pet owner client at the time of discharge.
vi. Consulting with the attending veterinarian by email for routine follow-up.
vii. Assistance with problem aftercare or complications. This will be either by phone if the issue is minor, or in hospital if more direct involvement is indicated.

 

c. Your hospital’s responsibilities:

i. Attending veterinarian must make the surgical diagnosis, perform all components of the pre-operative approval visit, ensure the patient is a safe candidate for anesthesia and surgery, ensure that there are no medical or surgical co-morbidities, and perform all follow-up recheck evaluations.
ii. Trained hospital staff must perform all aspects of the anesthetic episode, including patient recovery and discharge, and performing a one-day post-operative phone call

iii. Your hospital is responsible for all medication, drugs and equipment, other than surgical supplies unique to the procedure, which is supplied by ACL Surgery LLC,
iv. All communications with your pet owner client (other than the immediate post-operative communication to relay surgical findings).

v. We require your attending veterinarian, or other suitably trained hospital employee, to clearly communicate with the client who is performing the surgical procedure and to establish an accurate expectation that your attending veterinarian and other hospital employee’s will be continuing the patient’s post-operative care and pet owner client communications.

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d. The pet owner’s responsibilities are to:

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i. Your Pet Owner has been guided to review their Surgery Day Expectations and has been directed to read the Resources in Pet Owner Resources and were provided at the time of scheduling surgery, so that they are a knowledgeable and prepared owner to care for their pet.
ii. Following their post-operative discharge instructions.

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3. What are “hub-hospitals”:

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a. Note that this may not apply to your hospital if you are privately owned
b. Any hospital may schedule a procedure day as long as they meet the requirements detailed in the service agreement.

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i. Pricing is more favorable and scheduling priority is given to those hospitals booking multiple surgeries on a procedure day, and hub-hospitals may be used to pool surgeries from local hospitals under the same ownership into a single hospital location for that reason.

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4. How to schedule a surgery:

a. See Service Agreement

i. Because we make every attempt to only go to one hospital on any given procedural day, we request there to be two or more surgeries booked on that procedural day.

b. The Attending Veterinarian Scheduling Checklist must be completed, then you may schedule through the website 

i. Submit the form at the bottom of the website home page

c. If you have case related questions that you want to ask me prior to scheduling, then please email me directly (Albert@DrAlbertLynch.com)

i. Please refrain from texting or calling about case related issues, because this leads to an issue down the road when I forget what we spoke about or about our text conversation.

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5. How to organize and choreograph procedure days:

a. See Surgery Day Checklist and Service Agreement

6. Additional staffing requirements:

a. See your Service Agreement
b. There must be a staff veterinarian to perform a physical exam on the patient at the time of admitting to the hospital
c. Two anesthesia trained nurses
d. If you have more than one procedure scheduled, then you may use the same anesthesia capable nurse for each anesthetic episode, as long as you have additional nursing staff available for patient induction prep and to monitor each patient during the post-operative recovery period.

7. Additional equipment and facility requirements:

a. See your Service Agreement
b. Drugs: IV antibiotics (e.g. cefazolin) and full-mu opioids

i. Supplying Nocita through your hospital is encouraged*

c. General anesthetic capabilities: IV catheter, endotracheal tubes, injectable and inhalant anesthetics, ECG and non-invasive blood pressure monitoring.

d. A clean operating room of sufficient size to accommodate an additional table for sterile orthopedic equipment
e. Suction and cautery units are advised but not requirements

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8. Special note regarding infection control:

a. All patient preparation (especially clipping of hair), must be performed outside of the operating room.
b. The patient must have two scrubs with chlorhexidine scrub – The first is a rough scrub outside of the operating room that has an overall contact time of 5-minutes and acts to remove all gross debris/hair. The second scrub is a sterile scrub within the operating room, where you must wear sterile gloves and use autoclaved gauze

9. Discharged patients:

a. Every patient is sent home wearing a hard E-collar of appropriate size to prevent licking at incision, which will not be removed until their incision has healed (10-14 days)
b. Every patient is sent home with their discharge instructions and medications prescribed by the attending veterinarian:

i. Every patient is sent home with post-operative course of antibiotics for 10-14 days
ii. Every patient is sent home with anxiolytic medication (e.g. trazodone)
iii. Every patient is sent home with pain medication (e.g. NSAID + gabapentin)

c. Every patient >20kg should be sent home with a Help ‘em Up harness, or similar type support harness
d. A hospital staff member must call each patient the day following their surgery

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* The use of Nocita is required for most surgical procedures. It is highly recommended that your hospital provides this medication, and invoices the owner appropriately. If you do not wish to provide this medication through your clinic, then this must be stated at the time of your procedure booking so that ACL Surgery LLC is notified and able to provide this service at an additional fee.