What to Expect Before Surgery

Although it may differ slightly for each patient, the typical POSH process at Duke looks like this:

  1. Your surgeon will refer you to POSH if you are an older adult with one or more risk factors for complications after surgery.
  2. A member of the POSH team will ask you a series of questions over the phone about your health and support system.
  3. You will be scheduled for an appointment at the Duke POSH Clinic.
  4. At the POSH clinic, you’ll meet with a nurse and geriatrician from the POSH team, and a member of the Preoperative Screening Clinic.
  5. On the day of your appointment at the POSH clinic, you will have blood drawn if you have not had your blood tested recently.
  6. The POSH team will send you home with a written list of things to do to prepare for surgery, your hospital stay, and your return home.
  7. The POSH team may also recommend that you meet with another health professional, such as a physical therapist or a doctor who specializes in a condition you might have, such as diabetes or heart problems.
  8. The POSH team will also communicate with your surgical team to let them know of any medical issues that may need to be monitored closely during and after surgery.

You’ll meet with at least three people in the POSH clinic:

A medical assistant or nurse

who will assess your cognition, medications, mobility and functional status, nutrition and hydration. This step usually takes 30-60 minutes.

A nurse practitioner or PA from the Pre-operative Screening Clinic

who will let you know what to expect on your day of surgery and go over your information to make sure you’re healthy enough for surgery. This step usually takes about an hour.

A geriatrician

who will review the results of the assessments and will give you and your caregiver a list of instructions and strategies to give you the best chance of having a positive experience in the hospital and during the first days and weeks back at home. The geriatrician will also talk to you about pain management, advance directives, and your goals for surgery. This step may take up to an hour.