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VA Palo Alto Health Care System


New Surgical Pre-Op Allows Family Members

Before and after

The 'Do not Enter' sign has been removed and loved ones are now allowed to stay with the patient in the pre-operation holding area.

Friday, February 24, 2012

"This is how things were done for so long, and we just saw that it was time for some change," replied Operating Room/Post-Anesthesia Care Unit (OR/PACU) nurse Linda Mullen when asked what prompted her, along with nurses Debra Byrd and Rose Waltz, to push for a more Veteran and family centered pre-operation holding area. Prior to September 2011, there were two sets of thick double doors and a sign that read "DO NOT ENTER - Authorized Personnel Only" that separated Veterans from their families as they were being prepped for the operation room.  Outside, family and friends would anxiously wait three or four, sometimes even five hours, wondering what took so long to see their loved ones.

"My husband is very quiet, and I didn't want him to be alone like the last time," said the wife of a Veteran.

Staff, Veterans, and family members were familiar with the policy and followed it until a team of nurses - recognizing the potential to improve the experience for Veterans and their families - realized it did not have to be this way. Instead of having a pre-operation holding area, they envisioned an area where family would be welcome to wait with their loved ones as they were prepared for surgery.

In the fall of 2011, they brought the proposal to the Veteran and Family Advisory Council, a group made up of Veterans and family members who provide VA staff with their unique patient and family perspective. Advisory Council members embraced the idea and made sure to emphasize the importance of defining "family" as the Veteran defines it, be it family, friends, clergy, or social worker.

With the green light from the Advisory Council and the OR Committee, they were ready to pilot. Wanting to swap out the current cramped pre-operation holding areas for larger spaces that could accommodate family, they converted an area used for PACU storage into the new pre-operation holding area. Families were finally feeling welcome.

"I love being able to be with my wife. Last time I waited in the waiting room it was awful," said the husband of a Veteran.

The pilot was not a smooth transition as some OR staff had concerns about patient privacy and families interfering with care. Many felt their current policy was adequate. However, over the course of the two-month pilot, sentiments changed. Veterans, families, volunteers, and staff all began asking, "What can we do to make this permanent?"

Today, the picture in the pre-operation holding area looks much different than it did just a few months ago. There are family members holding hands with their loved ones. Veterans, comforted by familiar faces nearby, are at ease as staff prepares them for surgery. There are surgeons, nurses, and anesthesiologists greeting family members before surgery, assuring their loved ones are safe. There is less anxiety overall as families send off their Veterans into surgery, with a better understanding of the procedure and expected results.

Veteran and Family Centered Care empowers Veterans and family members with information and education, and promoting shared decision-making. Formed in early 2010, the Veteran and Family Advisory Council began meeting with staff to share ideas and perspectives about a variety of issues. Council input is considered thoughtfully and acted upon when possible.

Do you have an idea for how to make VA Palo Alto Health Care System more Veteran and family centered? Get the patient and family perspective from the Veteran and Family Advisory Council website.


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