Collaborative Practice

Coordination of Care

Whether you are a patient or a provider, when it comes to planning for an upcoming procedure HOC is here to help contribute to a positive patient experience.

HOC will provide orders and/or recommendations for treatment surrounding surgical procedures and any postoperative doses that may be needed. This is very important because most primary care physicians and or general surgeons do not know what treatment is needed for a bleeding disorder.

Coordination of Care Step-by-Step

1

HOC is notified by the patient or physician’s/ surgeon’s office

2

Procedure details are verified with physician’s/surgeon’s office

3

Orders are obtained from HOC’s hematologists

4

Orders are faxed to physicians/ surgeons' offices and any ancillary departments (ie surgery center, pharmacy, etc.

5

If patient will be receiving clotting factor medication at the hospital, HOC verifies with pharmacy that they can provide the medication If unable to, HOC has the ability to provide hospital with clotting factor medication

6

HOC then walks through a plan of care with the patient to ensure that the patient fully understands the plan of care

7

HOC will verify that all of the orders are set several days before the procedure

8

The day after the procedure, HOC staff will follow up with the patient and/or hospital staff to ensure there are no bleeding complications. Physician/Surgeons office is made aware that they should call HOC staff if there are any complications during the procedure. They are informed that HOC staff are on call 24/7

Specialty FAQ

Dental

Yes. By the time most patients seek care in a dental clinic they’re aware of their bleeding disorder and typically know how to manage it.

As with any new patient, a detailed medical history is critical to preventing medical emergencies while providing dental care. Identification of the type and severity of the bleeding disorder is critical to management. Determination of the invasiveness of the dental procedure is also important.

After determining the type and severity of your patient’s bleeding disorder, a consultation with the medical team at the Hemophilia Outreach Center is appropriate. At that time you can discuss the invasiveness of the planned procedures and measures necessary to ensure the patient is hemodynamically stable. For patients with moderate to severe hemophilia, factor replacement is often necessary.

Ensuring the patient will have normal coagulation prior to treatment, using a gentle technique and utilizing local hemostatic measures during care will minimize postoperative complications. Depending on the severity of the bleeding disorder and the invasiveness of the procedure, you may consider use of a post procedure EACA(Tranexamic acid) mouthrinse for several days.

Medication dosing will be dependent on the type of surgery the patient is having. HOC’s RN and Hematologist will work closely with the surgeon to determine the best plan of care.

HOC will help coordinate all follow-up doses

No, the patient would not need any medication(s) for a standard cleaning.

Please contact an HOC Nurse Coordinator, who will provide your office with a plan of care.