Your surgery is scheduled at: Maple Grove Hospital 9875 Hospital Drive Maple Grove, MN Your surgery is scheduled on: Day/Date:

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Your surgery is scheduled at: Maple Grove Hospital 9875 Hospital Drive Maple Grove, MN 55369 763-581-1002 Your surgery is scheduled on: Day/Date: Time*: a.m. p.m. Please be sure to arrive: Surgery Patients: 90 minutes prior to your scheduled surgery time C-Section Patients: 1½ hours prior to your scheduled surgery time Total Joint Replacement & Spine Surgery Patients: 2 hours prior to your scheduled surgery time * Occasionally we may have to change your surgery time due to emergencies or schedule changes. For this reason, we ask that you please keep the entire day of your surgery open. If a schedule change is necessary, we will make every effort to contact you. Your surgeon is: It is important that you: Read and follow ALL instructions in this booklet. Expect two telephone calls, one from a pre-admission nurse and one from the pre-registration department, during the week prior to your surgery. Complete the medication list in this booklet and bring it along with you. Complete all items on the checklist. Arrive for your surgery at the date and time noted above. For your safety you must have someone to drive you home and a responsible adult to stay with you for the first 24 hours after discharge. Contents Being Prepared for Your Surgery... 2 When Your Surgery is Scheduled...2-3 Medications, Pain Management & Pain Scale... 3 Day Before Your Surgery...3-4 Day of Surgery...4-5 Pediatric Patients... 5 Medication List... 5 Pre-Operative Checklist... 6 For Your Family... 7 Directions... 8

Being Prepared for Your Surgery When Your Surgery is Scheduled Elective surgery usually allows time to plan. Being well prepared for your surgery can help the process go smoothly and make your recovery much easier. By carefully following the instructions in this booklet, you will be better prepared and avoid the risk of having a delay or cancellation of your surgery. Once your surgery is scheduled, you will receive a call from Maple Grove Hospital Guest Services requesting an appointment for pre-registration. You will be offered two options. Please select an option that works best for you and your family. A pre-operation visit where you will be given a brief tour of the hospital and a one-to-one meeting to answer your questions. Pre-registration information will be obtained at this visit. A scheduled appointment for a pre-registration phone call. Insurance If you have any questions about insurance coverage, contact your health insurance company or your employer s personnel department. Private insurance - Maple Grove Hospital will work with your insurance company to provide info, as requested, to assist in the approval for your surgical stay. - Contact your private insurance company to see if pre-certification, authorization, referral or a second opinion is necessary. - Ask if your physician office needs to contact your insurance company regarding an authorization for an inpatient or outpatient procedure. Workers Compensation Insurance If you are planning to file a claim with workers compensation, inform your surgeon s office prior to your surgery and Maple Grove Hospital when you arrive for your surgery. Plan your home environment to accommodate any limitations you may have following surgery. Liability/ MVA Insurance If you are planning to file a claim through your liability/mva insurance, inform your surgeon s office prior to surgery and Maple Grove Hospital when you arrive for your surgery. Preoperative History and Physical (H&P) You MUST have a pre-operative physical thirty (30) days before your surgery or your surgery may be canceled. If you are over the age of 50 and have not had an EKG within the past 6 months you will need to have one done at your pre-op H&P as well. Please have your clinic fax the results of your H&P and EKG to 763-581-1325 upon completion. These results must be received at least 7 days prior to your surgery. You should also hand carry a copy on the day of your surgery to ensure we have this information. Special Needs If you are hearing impaired or need an interpreter, notify your surgeon s office. Maple Grove Hospital provides translator services at no cost to patients. Family members may not be used as interpreters per Maple Grove Hospital policy. Preparing to Go Home The success of your recovery depends on how well you plan for your recuperation at home. Ask your surgeon if you will have special needs or limitations after surgery and for how long. If you are going home the day of surgery, you MUST arrange for a ride home. Your ride home can wait for you at the hospital during your surgery or if they cannot stay, we will give them an estimated time to pick you up and receive discharge instructions. You MUST arrange for a responsible adult to stay with you for at least 24 hours after surgery. If this arrangement cannot be made, your surgery may need to be rescheduled until such time these arrangements can be made. PAGE 2

When Your Surgery is Scheduled Contact community resources if you need home assistance. Your doctor s office will be able to help you with the appropriate community resources. Medications, Pain Management & Pain Scale Fill out the medication list in this booklet (page 5) and bring it with you when you come to the hospital. Be sure to include ALL of your current medications and dosages, including over-thecounter medications and herbal supplements. The following medications that require special instructions from your physician at least one week prior to surgery are: Blood Thinning Medication Such as Aspirin, Coumadin, Plavix, Ticlid, Heparin, Lovenox, or any antiinflammatories (Advil, Aleve, Motrin). Diabetic Medication If you have diabetes, talk with your physician about the dose of medication you should take the day of surgery. Diuretics Generally are NOT taken the day of surgery. Antidepressants You may take your usual dosage of the following medication the morning of surgery (take with a small sip of water only): - Blood pressure medicine - Heart medicine - Seizure medicine - Asthma medicines (including all inhalers) - Pain medicine up to 4 hours before your scheduled surgery time (if necessary) Do not bring any medications to the hospital with you unless you are instructed to do so. Pain can be expected because of the surgical interaction that has occurred. Pain medicine will be available to help manage this. We recognize each patient s pain perception is unique and may vary based on his/her experience and the nature of the procedure. Our mission is to manage pain and other issues that may pose a barrier to your loved one s comfort, while addressing safety concerns. Worst Possible Pain Very Severe Pain Severe Pain Moderate Pain Mild Pain No Pain You may use the 0-10 scale for self-assessment. Use the faces or behavioral observations to interpret expressed pain when you cannot communicate your pain intensity. Day Before Your Surgery Special Instructions Fill out medication record and bring along to the hospital Review medication instructions If you are a diabetic, make sure you have talked with your doctor about plans for adjusting your medication the day of surgery. Notify your surgeon if you experience a change in your health, including cold symptoms, skin abrasions or infections. If you have not been contacted by our pre-admission nurse by 3 p.m. the day before your scheduled procedure, please call 763-581-1120 between the hours of 6:00 a.m. and 7:00 p.m. to obtain instructions. PAGE 3

Day Before Your Surgery Eating and Drinking Instructions Follow ALL instructions unless your surgeon gives you special instructions: Eat a normal meal the evening before surgery. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT (Gum chewing and hard candy are not allowed). If your surgery is scheduled to start after 12 noon, you may have one glass of water before 8 AM unless directed otherwise by surgeon. Infants (birth to 12 months) may have formula up to 6 hours before surgery, breast milk up to 4 hour before surgery, and clear liquids (water or apple juice) up to 3 hours before surgery. Failure to follow these instructions may result in cancellation of your surgery. Before You Leave Home Strictly observe the eating and drinking instructions. You may brush your teeth but do not swallow any water. Follow the instructions for taking your medication. Make sure all items on the checklist have been completed. Shower before leaving home to decrease skin bacteria and lower the risk of infection. Your physician may direct you to use an antiseptic soap. Follow directions on map (located on back page) to Maple Grove Hospital. Day of Surgery What to Bring Along to the Hospital Your completed medication list. Any papers your physician has given you (for example, H&P and EKG). Insurance information (insurance card, Medicare/Medicaid card, prescription card). Picture I.D. for registration. Comfortable, loose-fitting clothing (elastic waist band). Consider the site of your surgery and if you will have a cast, brace, etc. (Short pants work well). A copy of your living will, power of attorney, or advanced directive. A storage case for eyeglasses or contact lenses. Crutches or walker. These may be left in your car. CPAP, Pacemaker / ICD manufacturer information and model, inhalers. What to Leave at Home ALL valuables including jewelry, rings, body piercings, purse, wallet. Maple Grove Hospital is not responsible for lost or damaged property. No makeup, deodorant, perfume, or aftershave. Maple Grove Hospital is a fragrance free facility. No fingernail polish. Acrylic nails or nail tips need to be removed ONLY if you are having hand, shoulder or wrist surgery. When You Arrive at Maple Grove Hospital Check in at the Welcome Desk located in the main lobby. Once you have been welcomed and the necessary paperwork has been completed, you will be called to the Procedural Care Center to change into hospital clothing and your belongings will be placed in a locker. Your family members may join you when you are changed and settled in your room. They can stay with you until your surgery time. If you are arriving for a C-Section, you will be greeted and escorted to the Family Birth Center. PAGE 4

Day of Surgery Before Your Surgery The time preceding your surgery is a very busy and important time. You will receive visits from several members of our surgical team. They include: Nurse, CRNA, Anesthesiologist, Surgeon. If your child is having a surgical procedure, we recommend that you talk about what to expect at the hospital. Children who are well-prepared are less frightened about coming to the hospital. Visiting the hospital before their procedure is an excellent way to prepare children for their upcoming surgery. Pediatric Patients (birth to 17 years) Hospital Considerations Minors must be accompanied by a parent or legal guardian, one of whom must remain within the hospital at all times. Your child may bring a special blanket or toy along to the operating room. You may stay with your child until just before surgery begins. If your child needs to stay overnight in the hospital, a parent may stay in the room. You will want to give your child your undivided attention. For this reason, it is best not to bring other children along. Daycare for your child is not recommended the day of surgery. Medication List Medication Dosage How often do you take this med? Why do you take this med? Date and time of last dose taken Special concerns or questions you have regarding your surgery: PAGE 5

When Your Surgery is Scheduled o Contact your insurance company about pre-authorization requirements. o File a workers compensation claim (if applicable). o Complete pre-operative physical examination within 30 days of your surgery. o Communicate any special needs to your surgeon s office. o Make arrangements for someone to drive you home and a responsible adult to stay with you for 24 hours after discharge. For your safety you will not be able to drive or leave the hospital alone. If this arrangement cannot be made, your surgery may need to be rescheduled until such time these arrangements can be made. Pre-Operative Checklist o Understand and follow your doctor s medication instructions. o A pre-admission nurse will call you the week of your surgery. The purpose of the call will be: Review your medical prescriptions and medical history Inform you what medication to take the morning of your surgery o A Pre-Registration Call Gather insurance information - Insurance Name Phone # - Policy and Group number - Name, address & phone # of your employer (name) (address) (phone) - Social Security # Check to see if you have contacted your insurance company Day Before Your Surgery o If you have not received a call from the pre-operative nurse, please call 763-581-1120 between the hours of 6:00 a.m. and 7:00 p.m. to confirm your arrival time, review your medical history, and receive final instructions. o Avoid smoking, gum chewing, and alcohol. Day of Surgery o Understand and follow medication instructions. Take only the medication approved by the pre-admission nurse. o Do not eat or drink anything. o Remove ALL jewelry, rings, and body piercings. o Bring medication record with you to the hospital. DO NOT bring any medication unless instructed to do so. o Review list of items to bring along to the hospital (page 4). o Shower to decrease skin bacteria. For More Information Guest Services: 763-581-1002 PAGE 6

For Your Family Patient s Family & Friends At Maple Grove Hospital we know that surgery can be a stressful time for both the patient and the patient s family & friends. We are committed to providing excellent and compassionate care for your loved one. To help make your stay comfortable, here is a brief summary of what you can expect. For Your Family Prior to Surgery After the patient checks in at the Welcome Desk, he/she will be escorted to the Patient Care Center where he/she will get ready for the procedure. This will take approximately 30-40 minutes. After that, family/friends can be invited to sit with the patient prior to surgery. During this time, friends/family has an opportunity to speak with the nurse, doctor and anesthesiologist. Family/friends receive a pager and patient tracking number. The pager is used to contact you if you have stepped away from the waiting area. The tracking number, located below the clock in the waiting area, will help you track the patient s progress. During Surgery/Procedure Patient s family/friends can wait in the surgical waiting area. If you are paged while waiting in the hospital, please return to the Welcome Desk and check in with one of the Guest Services Representatives. If there are any updates on the patient s progress, a Guest Services Representative will page you if you leave the waiting area. If you plan to leave the hospital, please let one of the Guest Services Representatives know and provide them with a phone number where you can be reached and an estimated return time. Please note, the pager does not work outside of the hospital. The patient s surgeon will provide you with an update after the surgery/procedure. This will usually take place in a consultation room or a private corner in the waiting area. After Surgery When surgery is complete, the patient is moved to the Recovery Room. Patients can be in the Recovery Room for 1-2 hours. When the patient is ready, they will be moved to Phase 2 Recovery, or to their assigned room in the hospital. For Same Day Surgery patients, the doctor and/or nurse will provide discharge instructions to the patient and patient s family/friends. You will be invited to join the patient in Patient Care Center prior to leaving the hospital. For inpatients, a Guest Services Representative will inform you when the patient goes to his/ her assigned room. Note If you have any questions or concerns at all during your time here, please do not hesitate to speak with a Guest Services Representative at the Welcome Desk. We are happy to help you. PAGE 7

Maple Grove 81 81 Directions County Rd 30 Dunkirk Ln Exit 213 Maple Grove Pkwy Exit Home Depot Grove Circle N H Hospital Dr Upland Ln N Target Maple Grove Pkwy 99th Ave Fernbrook Ln N Maple Grove Senior High School Hwy 610 Elm Creek Blvd 93rd Ave N 93rd Ave N 81 If coming from the south or east: Take the Maple Grove Parkway/95th Ave. exit off of I-94. Take a right on Maple Grove Parkway. Follow Maple Grove Parkway to Hospital Drive. Go left on Hospital Drive. Maple Grove Hospital will be on your left at 9875 Hospital Drive. If coming from the north or west: Take the Maple Grove Parkway exit off I-94. At the light, take a right on Maple Grove Parkway. Follow Maple Grove Parkway to Hospital Drive. Go left on Hospital Drive. Maple Grove Hospital will be on your left at 9875 Hospital Drive. If coming from the west or east on Highway 81: Maple Grove Hospital is just off of Highway 81 and Maple Grove Parkway in Maple Grove. If traveling on Highway 81 from the east (from the Champlin area), you would take a left on Maple Grove Parkway. If traveling Highway 81 from the west (the Rogers area) you would take a right on Maple Grove Parkway. Follow Maple Grove Parkway to Hospital Drive. Go right on Hospital Drive. Maple Grove Hospital will be on your left at 9875 Hospital Drive. 9875 Hospital Drive Maple Grove, MN 55369 763-581-1000 maplegrovehospital.org 2014 Maple Grove Hospital_SW335