Academic Observership

	Dr. Devan Bhagat, Attending Anesthesiologist, (L) greets Dr. M. Nedim Aytekin, Visiting Physician, from Fatih University, Ankara, Turkey

We receive numerous requests from anesthesia practitioners who are interested in visiting HSS to observe our clinical practice. Visiting physicians hope to see new regional anesthesia techniques, gain an improved understanding of our systems and processes, and obtain advice on effective methods to employ in order to implement a regional anesthesia program at their home institution. Due to the busy nature of our practice, the number of physicians in our training programs, and especially in consideration of our patients and staff, we must limit visits to a maximum of two days. This program is open to attending physicians only.

All requests for academic observerships must beapproved by the Department Director - Dr. Gregory Liguori. A request must be submitted in writing at least two weeks in advance of the proposed visit date(s), on institutional letterhead, and include the requesting physician's full name, current affiliation, and contact information. Requests should be addressed to:

Gregory A. Liguori MD,  Director and Anesthesiologist-in-Chief

Department of Anesthesiology
Hospital for Special Surgery
535 East 70th Street
New York, NY 10021

Requests may also be faxed to Dr. Liguori’s attention at 212.517.4481.

When a request is approved, the visiting clinician will be contacted by Sheryl Stebel, Assistant to Dr. Liguori.  Once permission is granted for an academic observership, the visiting physician should complete the “Visitor Health Form” and “Visitor Application” (downloadable from this page). Both forms must be completed and returned to Ms. Stebel, along with the visiting physician’s  CV, at least five workdays prior to their visit. They may be faxed to 212-517-4481; attn: Sheryl Stebel or e-mailed to stebels@hss.edu.  If you have any questions and wish to speak to Ms. Stebel directly, her telephone number is 212.606.1206.

Upon arrival, visiting physicians are asked to come to the Anesthesia Office, Suite 835 West, in the Hospital, at a pre-arranged time - after 9:00 AM, to meet Ms. Stebel.  Upon confirmation that all documentation criteria has been satisfied, the visiting physician will be brought to the Education Division Office to register and confirm identification. Visitors are required to bring a valid photo ID/passport. Please note that visitors will not be approved without verifying identification.

Following registration with the Education Division, a member of the Anesthesiology Team will accompany the visiting physician to our clinical settings where he/she will meet Dr. Enrique Goytizolo, Director of our Academic Observership Program, or a member of our Academic Observership Team, who will serve as host. Dr. Goytizolo, or his designee, will discuss the purpose of the visit and then arrange an appropriate observation schedule.

All visiting physicians must adhere to the OR Visitor Guidelines (Attachment “A”)

At the conclusion of the visit, all visiting physicians are expected to return their temporary visitor identification and complete an evaluation in the Education Division Office.

We are aware of the limitations of brief visits and suggest that visiting physicians consider attending our annual Regional Anesthesia Symposium, which features hands-on workshops as well as didactic sessions, if they would like to gain a more comprehensive overview of our practice. For more information on our Symposium, please follow the prompts on the home page of this website.

If you have any questions regarding our departmental Academic Observership Program or any of our Department Academic Activities, please contact Mary Hargett, Assistant Director, Education, at 212.606.1793, or hargettm@hss.edu

Please click on the following links to download the forms:

• Visitor Health Form
• Statement and Certification of Visitor Seeking Admission
  

 

Hospital for Special Surgery
Perioperative Services

OR Visitor Guidelines

All visitors to the OR who meet the requisite standards set forth in the HSS Perioperative Service Structure Standards must adhere to the following  practices while inside the OR.
These guidelines have been developed to ensure patient, staff and visitor safety.  Failure to comply will result in being escorted from the OR.

Standard and Transmission-Based Precautions
Specific practice guidelines are in place to protect patients and health care workers from exposure to bloodborne and body fluid pathogens, which are primary potential sources for transmission of disease. Standard precautions to prevent pathogen transmission are to be used during all invasive procedures and apply to any exposure or potential for exposure to all body fluids and excretions except sweat, non-intact skin and mucous membranes.

• Includes use of personal protective equipment (PPE) whenever there is a potential for exposure to potentially infectious material.
• PPE includes: gloves, gowns, masks, eye protection and shoe covers, if indicated.
• Prompt and frequent handwashing is the single most important measure in reducing the transmission of microorganisms.  Hands are to be washed before entering and upon leaving the OR.
• HSS prohibits eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses in the Operating Suites.
• Visitors who have exudative lesions or weeping dermatitis, headcold, productive cough, fever or any other signs or symptoms of illness are prohibited from entering the OR.

Transmission-based precautions are used in addition to standard precautions for patients who are known or suspected to be infected with highly transmissible diseases and include airborne, droplet and contact precautions.  Visitors will be prohibited from entering ORs  where transmission-based precautions are in effect unless specifically directed by the attending surgeon.

Surgical Attire
All visitors who enter the semi-restricted and restricted areas of the OR Suites are required to wear freshly laundered scrubs.  The scrubs are to be worn only inside the OR.  Visitors are prohibited from wearing scrubs outside the OR and outside the hospital.

• Visibly soiled, contaminated or wet surgical attire must be removed as soon as possible and replaced with fresh, clean surgical attire.
• Clothing that cannot be covered completely by surgical attire is not to be worn in the OR.
• All hair is to be confined and covered.  Visitors with beards and mustaches are required to wear surgical hats that cover facial hair and masks.
• A bald or shaved head is covered to prevent shedding of skin cells.
• A single surgical mask that covers both mouth and nose is to be worn in the restricted areas of the OR Suites
• Masks are discarded upon exiting the OR and are not to be left hanging around the neck or tucked in a pocket.
• Jewelry worn by visitors should be reduced to an absolute minimum i.e. wedding ring and watch to prevent contamination.

Traffic Patterns
Traffic control practices protect personnel, patients, supplies and equipment from potential sources of cross-contamination.  Surgical suites are divided into three designated areas:

          Unrestricted- street clothes are permitted and traffic is not limited

          Semirestricted- peripheral support areas outside the actual OR, including storage and processing areas and corridors. Traffic is limited to authorized personnel who are required to wear surgical attire and a surgical cap or hood.

          Restricted- ORs and procedure rooms. Full surgical attire is required.  A mask is required if sterile items are opened or scrubbed people are present.

• OR doors are to remain closed at all times. Open doors cause turbulent airflow which can increase airborne contamination.
• Talking and the number of people present during a procedure should be reduced to a minimum. Conversation is to be restricted and the OR phone is not to be used by visitors at any time. Cell phones and pagers are to be set to ‘VIBRATE’. Frequent entries and exits are prohibited.  If the circulating RN, in her professional judgement, deems that the number of extra personnel in the OR negatively impacts the safety and well-being of the patient, steps will be taken to minimize the number of personnel in the room.
• Supplies and equipment are to be removed from external shipping containers in the unrestricted area before transfer into the OR.  External shipping containers collect dust, debris and insects and may transfer contaminants inside the OR.

Reducing Radiological Exposure
Exposure to radiation should be minimized by all personnel.

• Personnel are to stand at least 6 feet away from the x-ray tube and wear lead aprons and thyroid shields
• Lead aprons are to be hung up after use, not folded or laid flat on a surface or across a chair to prevent cracking of the lead and reducing effectiveness.