HSS ASC of Manhattan

Most of the surgical procedures are performed using regional anesthesia (spinal, epidural or nerve block are all types of regional anesthesia). Regional anesthesia numbs the nerves around the part of the body being operated on, producing partial or total temporary loss of sensation in that area. Most patients undergoing regional anesthesia also chose to receive intravenous sedation, which allows them to sleep during the operation. In some cases you may be able to stay awake during your procedure. Patients who undergo regional anesthesia generally have better pain control and are less likely to report feelings of nausea or vomiting following surgery.

While regional anesthesia is the most common anesthetic technique, general anesthesia is preferable in some cases. General anesthesia numbs the entire body and makes patients unaware of everything occurring in the operating room. Patients undergoing general anesthesia return to consciousness after the surgery is complete.

You and your anesthesiologist will discuss what type of anesthesia is best for you before your procedure, with the goal of keeping you safe and comfortable.

Our anesthesiologists regularly employ techniques (such as regional anesthesia) to reduce the risk of post-operative nausea and vomiting, and routinely give anti-nausea medications as part of your anesthetic care.

If you have a history of nausea and vomiting following surgery, please inform your anesthesiologist before surgery. He or she will make necessary adjustments to the anesthetic plan to ensure the best approach to prevent or minimize these side effects.

Orthopedic surgery is often associated with post-operative pain, and pain control is one of our top priorities. We have a variety of proven methods to keep you comfortable and safe. If you are scheduled for an outpatient procedure, your anesthesiologist will make sure that your pain is manageable before you are discharged.

As your surgery date approaches, there are several important things to keep in mind and prepare for.

• Arrange for an escort. By law and for your safety, the HSS ASC requires that patients arrange for a responsible adult over the age of 18 to escort them home. Your surgery may be cancelled if you do not have a confirmed escort present prior to the procedure.
  
  Listed below are some private medical escort services you may want to contact if you do not have anyone to bring you home:
  • Devotion Home Car, 212.706.3861
  • Allure Home Care, 646.994.0191
  • VNS Health, 888.735.8913    
     
• MyHSS setup. You will be sent an email from HSS to set up a patient portal called MyHSS. MyHSS allows you to access some records, send messages, set up appointments, and much more. You will also have to access MyHSS to answer the ASC Surgical Screening Questionnaire, which provides our anesthesiologists with important information in order to provide you with the best possible care.
• Getting help at home. If possible, arrange for someone to stay with you at home or to be available for at least 48 hours to assist you with activities of daily living.
• Pick up medications. Some surgeon offices prescribe medications the day before surgery, giving patients one less thing to worry about the day of surgery. Speak with your surgeon about this option.
• Learn how to use medical devices. It is important to speak with your surgeon about the medical equipment you will be using after surgery. Crutches, cold therapy units, and even some slings need some instruction on how to use them. Ideally, this is done before the day of surgery to give you time to get comfortable with the equipment. 
• Plan for physical therapy. Before your surgery, discuss with your surgeon the need for physical therapy including when it will start. Take the time to learn about outpatient rehabilitation facilities. 

• What to Bring

  On the day of surgery, please only bring necessary documents and items as directed by HSS ASC staff.

  • Legal government-issued ID you used when scheduling your surgery with your doctor
  • Health insurance and prescription cards
  • Medical information as requested by HSS ASC staff and physician, such as lab reports, advance directives and immunization status information
  • List of medications, including how often you take them, indication and dosage
    (Do not bring medications with you on the day of surgery unless instructed by staff)
  • Dentures, eyeglasses and essential medical equipment such as crutches, braces, sleep apnea settings and masks. 

  The HSS ASC is committed to providing a safe and secure environment during your stay. In order to keep your belongings safe, we kindly request that you do not bring any valuables or unnecessary personal belongings (e.g., suitcases, jewelry, cash, medical equipment, etc.) with you.

  Please pack lightly as HSS ASC of Manhattan staff cannot secure and store multiple bags, suitcases, luggage or backpacks for you or your visitors. Belongings that fit into a storage bag issued by the HSS ASC of Manhattan will be secured and stored for you while you are in the operating room. Any additional personal belongings will be given to your designated visitors or family members for safekeeping. The HSS ASC of Manhattan will not be responsible for any lost or misplaced personal belongings that were not secured by staff.

• What to Wear

  Please wear casual, loose-fitting clothing and athletic footwear. You will be provided with a gown to wear during your procedure.

  • If you are having upper extremity surgery on your shoulder, elbow or hand, a very loose button-down shirt is recommended.
  • If you are having lower extremity surgery on your knee, foot or ankle, loose-fitting sweatpants or shorts are recommended to accommodate the bandage, or brace.
• Where to Go

  If arriving at the HSS ASC of Manhattan by car, please use the patient pickup/drop off entrance located at 248 E 65th Street. Otherwise, please use the main entrance at 1233 2nd Ave. Upon entering the building, reception can be found on the second floor, which is accessible by elevator. At reception, the admitting assistants will complete your admission process, have you sign a few documents, and place an I.D. bracelet around your wrist. After completing check-in, you’ll view a short welcome video while you wait to be called into the pre-surgical holding area.

  Patients will be brought into the holding area by a nurse, and after a quick assessment, your visitor will then join you. Once the patient is called for surgery, visitors will be directed to the waiting area. After surgery, your physician will speak to your visitor about your condition. Your visitor will be notified when you are taken to the recovery room and when you can be seen. Please remind your visitor to remain in the waiting area or to let the desk staff know if they must leave.

• Recovery Area Visitation Information

  To ensure the safety, comfort and privacy of all the patients in the Recovery Area, we ask that everyone follow these guidelines:

  • Patient/Nurse Liaisons must accompany visitors to the Recovery Area during all visits.
  • One visitor is permitted for every patient, including pediatric patients. Special requests for another visitor can be made through HSS’ Office of Service Excellence, your surgeon’s office will be able to help with the request. 
  • Food, drinks, flowers and gifts are NOT permitted in the Recovery Area.
  • Cell phone use is allowed in designated areas only. This is for the comfort and privacy of all.
  • Children under 14 are not permitted at the ASC of Manhattan, unless they are a patient.

In the recovery room, the nursing staff will provide the necessary care for you and monitor your return to meet discharge criteria. In order to be discharged from the recovery room to home, you must meet our established discharge criteria:

• Stand up and walk without feeling excessively dizzy or lightheaded. 
• Tolerate food and liquids with minimal nausea.
• Have the ability to urinate if you have received a spinal anesthetic.
• Have your post-operative pain controlled.
• Can demonstrate the proper use of crutches, walkers, or cane, as prescribed by your surgeon.

Depending on the type of anesthesia you receive, you will stay at the HSS ASC until your condition is stable and it is deemed safe for you to leave.

When it is time for you to leave, the person escorting you home will be asked to bring the car to the 65th Street entrance. We ask that the driver please be patient if there is a prolonged wait. HSS ASC personnel will escort you to the car and assist in your departure.

You will not be allowed to drive yourself home. Keep the number of people who accompany you to one. We follow national standards that do not permit children under the age of 14 to accompany you on the day of hospital discharge.

If your driver does not plan to wait at the HSS ASC of Manhattan during your surgery, please ask your nurse for an estimated discharge time and then inform the person giving you a ride to be ready at that time. We also ask that you give the nurse a phone number where we can contact the person giving you a ride home. Individuals picking up patients upon discharge should bring pillows for patients to use during transport.

As a patient in an ambulatory surgery center in New York State, you have the right, consistent with law, to:

1. Receive services without regard to age, race, color, sexual orientation, religion, marital status, sex, disability, sexual orientation, gender identity or expression, national origin or sponsor.
2. Be treated with consideration, respect and dignity including privacy in treatment.
3. Be informed of the services available at the center.
4. Be informed of the provisions of off-hour emergency coverage.
5. Be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the availability of free or reduced care costs.
6. Receive an itemized copy of his or her account statement, upon request.
7. Obtain from his or her health care practitioner, or the health care practitioner’s delegate, complete and current information concerning his or her diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand.
8. Receive from his or her physician information necessary to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, as a minimum, the provision of information concerning the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision.
9. Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of his or her action.
10. Refuse to participate in experimental research.
11. Voice grievances and recommend changes in policies and services to the center’s staff, the operator and the New York State Department of Health without fear of reprisal.
12. Express complaints about the care and services provided and to have the center investigate such complaints. The center is responsible for providing the patient or his/her designee with a written response within 30 days if requested by the patient indicating the findings of the investigation. The center is also responsible for notifying the patient or his or her designee that if the patient is not satisfied by the center response, the patient may complain to the New York State Department of Health’s Office of Health Systems Management.
13. Privacy and confidentiality of all information and records pertaining to the patient’s treatment.
14. Approve or refuse the release or disclosure of the contents of his or her medical record to any healthcare practitioner and/or healthcare facility except as required by law or third-party payment contract.
15. Access his or her medical record pursuant to the provision of section 18 of the Public Health Law, and Subpart 50-3 of Title 10 of the Compilation of Codes, Rules and Regulations of the State of New York.
16. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
17. Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card available from the center.

Descargar en español

The HSS ASC of Manhattan is committed to providing high quality care and skilled and compassionate service to our community. Consistent with this commitment, the HSS ASC of Manhattan complies with applicable federal, state, and local civil rights laws and does not discriminate on the basis of actual or perceived race, color, creed, ethnicity, religion, national origin, alienage or citizenship status, culture, language, age, disability, socioeconomic status, sex, sexual orientation, gender identity or expression, partnership or marital status, veteran or military status, or any other prohibited basis.

The HSS ASC of Manhattan :

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • Qualified sign language interpreters; and
  • Written information in other formats, such as large print, audio, and accessible electronic formats.
• Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreters; and
  • Information written in other languages.

If you need these services, contact Bella Elogoodin, Senior Director, languageservices@hss.edu, Tel.: 1.212.606.1760.

If you believe that the HSS ASC of Manhattan has failed to provide these services or discriminated in another way, you can file a grievance with Bryan Guss, Senior Director, HSS ASC of Manhattan, 1233 Second Avenue, New York, NY 10065, TTY: 1.800.676.3777, Fax: 212.548.2510, gussb@hss.edu.

You can file a grievance in person or by mail, fax, or email.  If you need help filing a grievance, you may contact the office of Bryan Guss for assistance. 

You also have the right to file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Complaint Portal Assistant, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1.800.368.1019, 800.537.7697 (TDD).  Complaint forms are available at U.S. Department of Health and Human Services Office for Civil Rights. 

ATENCIÓN: Si usted habla español, le avisamos que tenemos servicios lingüísticos gratuitos a su disposición. Llame al: 1-212-606-1760, TTY: 1-800-676-3777.

注意：如果您講中文，可向您提供免費語言服務。致電 1-212-606-1760，TTY: 1-800-676-3777。

Внимание: Если Вы говорите по русски, примите к сведению, что Вы можете воспользоваться бесплатными услугами переводчика. Звоните по номеру: 1-212-606-1760, TTY: 1-800-676-3777.

ATANSYON: Si ou pale Kreyòl Ayisyen, gen sèvis asistans nan lang ki disponib pou ou gratis. Rele nan 1-212-606-1760, TTY: 1-800-676-3777.

알려드립니다: 귀하께서 한국어를 하시는 경우, 무료로 언어 도움 서비스를 이용하실 수 있습니다. 1-212-606-1760 (TTY: 1-800-676-3777) 번으로 전화하십시오.

ATTENZIONE: se parli italiano sono disponibili servizi di assistenza linguistica gratuiti. Chiama il numero 1-212-606-1760, TTY: 1-800-676-3777.

אכטונג׃ אױב איר רעדט אידיש, זענען פאר אײך דא צו באקומען שפראך הילף סערװיסעס פרײ פון אפצאל. רופט 1-212-606-1760, TTY: 1-800-676-3777.

দৃষ্টি আকর্ষণ: যদি আপনি বাংলায় কথা বলেন, তাহলে আপনি বিনামূল্যে ভাষাগত সহায়তা পরিষেবা পেতে পারেন৷ ফোন করুন: 1-212-606-1760, TTY:  1-800-676-3777

UWAGA: Jeżeli mówi Pan/Pani po polsku, dostępne są dla Państwa bezpłatne usługi pomocy językowej. Proszę zadzwonić pod numer 1-212-606-1760, TTY:  1-800-676-3777.

ملاحظة: إذا كنت تتحدث اللغة العربية، فإننا نوفر لك خدمات مساعدة لغوية بالمجان. اتصل على
1-212-606-1760، هاتف نصي (TTY): 1-800-676-3777.

VEUILLEZ NOTER: Si vous parlez français, des services d’assistance linguistique gratuits, sont à votre disposition. Appelez le 1-212-606-1760, TTY: 1-800-676-3777.

توجہ فرمائیں: اگر آپ کی زبان اردو ہے تو آپ کے لیے زبان میں معاونت فراہم کرنے والی سروسز (لینگوئج اسسٹنس سروسز) بلامعاوضہ دستیاب ہیں کال کریں 1-212-606-1760 TTY: 1-800-676-3777۔

PAUNAWA: Kung nagsasalita ka ng Tagalog, may makukuha kang mga libreng serbisyo ng tulong sa wika. Tumawag sa 1-212-606-1760, TTY: 1-800-676-3777.

ΠΡΟΣΟΧΗ: Εάν μιλάτε ελληνικά, διατίθενται δωρεάν υπηρεσίες γλωσσικής βοήθειας για εσάς. Καλέστε το 1-212-606-1760. TTY: 1-800-676-3777.

VINI RE: Nëse flisni shqip, keni në dispozicion shërbime ndihme për gjuhën pa pagesë. Telefononi 1-212-606-1760, TTY: 1-800-676-3777.

Download in English | Español (Spanish) | 中文 (Chinese)| Русский (Russian)

Be an active partner in your care

Together with The American Association for Ambulatory Health Care (AAAHC), we urge patients to become involved in their care through a program called “Speak Up.” “Speak Up” offers simple advice on how you can make your care a positive experience. Research shows that patients who take part in decisions about their healthcare are more likely to have better outcomes.

“Speak Up” means:

• Ask questions if you have concerns or do not understand something about your care.
• Let us know if English is not your primary language – we will gladly get you an interpreter.
• Say something if you think you are about to receive the wrong medication or if you think the healthcare professional has confused you with another patient.
• Ask members of your healthcare team if they have washed their hands prior to delivering care.
• Share your complete medical history with your healthcare team.
• Tell us if you have any allergies.
• Ask a trusted family member or friend to be your advocate.

Seeking education about your medical issues and your treatment allows you to be a better partner in your care. Good communication with your healthcare team benefits everyone. Letting us know your issues and concerns

helps us in your care and also keeps you involved as an active partner. Feel free to ask your nurse and other members of the healthcare team to address your concerns.

Know what medications you take and why and when you take them

• Have your list of all the medications you are currently taking, as advised, prior to admission. This includes prescriptions and over- the- counter items like vitamins, herbal supplements, pain relievers, antacids and allergy medications.
• Also have your contact information for your primary care doctor, or the doctor who will be following your care once you leave the HSS ASC of Manhattan, including their name, telephone number and fax number.
• Always ask about any medication that is given to you and know why you are taking it.
• Carefully review the medications you are to take once you leave the HSS ASC, and be sure you have the prescriptions and that you understand the discharge and follow-up instructions.
• Please throw away any old medication lists and update your records with any retail pharmacies or providers.
• Should you be discharged on medications such as Xeralto or Lovenox, which are anticoagulants (medications to prevent blood clots), our nurses will provide careful teaching to you and your family or caregivers as to dose, time, diet and follow-up instructions that are all very important for your safety.

Check and double check identification

• Patient identification: You are given an HSS ASC identification (ID) band when you arrive at the HSS ASC of Manhattan. This ID band has your name, date of birth (DOB) and medical record number which helps us to identify you and ensures that we are giving you the proper care and treatment. You will find that your healthcare team will check your ID band and ask for your name and DOB throughout your stay. Please know that this is for your safety. If your ID band falls off or is not easy to read, please ask us for another one.
• Surgical site identification: You will be asked to identify the correct surgical site by pointing to the area where you are due to have surgery, at which time your surgeon will initial the correct surgical site using a special marker. Another safety measure that happens right before your procedure is a “Time Out,” in which the healthcare team will confirm patient identity, surgical site, correct procedure and surgery consent form.

Preventing infections

Hand washing is one of the best ways to prevent the spread of infection. HSS ASC of Manhattan staff members are aware of this and will clean their hands with either soap and water or a sanitizing solution (Purell) before and after they provide care for you. If you have not seen someone on your healthcare team wash their hands, we suggest that you ask them to do so.

Avoid falls

• Always press the call bell for help before getting out of bed or while in the bathroom. Your room has many things like foot stools and tray tables that may need to be moved for you to walk safely.
• Always check to see what tubing is connected to you before getting out of bed—for example, IV, pain pump, catheter, or airflow foot pumps.
• Use your cane, crutches or walker as directed.
• Use the handrails in the bathroom as needed.
• Wear your eyeglasses or contact lenses to clearly see your surroundings and to help you with balance.
• Wear non-slip footwear.
• Do not self-medicate while you are in the HSS ASC – your doctor or nurse will give you your medications at the HSS ASC of Manhattan.
• Be aware, if you have been given a nerve block, that it can take a long time to wear off and may have an effect on your ability to stand or walk safely.
• Be sure to tell us if you feel dizzy or drowsy for any reason.

Remembering these things and making sure to press the call bell when you want to move about will help you to stay safe and have a good recovery.

Your Partners in Care and Safety

Now that you have reviewed this information, you have learned many ways to keep yourself safe throughout your time at the HSS ASC. Of course, you are not alone in this effort. Your healthcare team and the entire staff at the HSS ASC are committed to excellence in all that we do. As such, it is our goal to ensure the highest level of safety for our patients. Remember, “Speak Up”, ask questions, share concerns and be mindful of your surroundings. We welcome you as partners in your care and we look forward to getting you up and moving, safely, to a better quality of life.