Assessment by Anesthesia Resource Center (ARC)

Pre-Procedure History and Physical (PPHP) should occur no more than 30 days from procedure day to evaluate for health issues that may impact plan of care for surgery
or anesthesia.
PPHP may be completed by either a face-to-face (ARC) visit prior to day of service or phone history/screening prior to day of service and subsequent physical exam on day of service.
PPHP serves as the admission H&P, if applicable.
PPHPs are completed by the ARC team for all anesthesia locations at PHL and KOPH.
- Exceptions: Cardiac surgery, GI suite
- Ambulatory Surgery Center (ASC) RNs complete screening prior to procedure. Anesthesia completes physical exam on day of procedure.
When available, utilize Procedure Pass pools in Epic for all communication.

Select an option below in the case request order to ensure PPHP is completed by appropriate team.

ARC Pre-Visit Type	Criteria
No Pre-Visit (NPV)	Has an Anesthesia Care Team provider regardless of complexity or Does not require complex care coordination
Periop Home Consult (PHC)	Does not have an Anesthesia Care Team provider And at least one of the following: Requires care coordination due to multiple co-morbidities managed by subspecialist(s) Followed by Cardiology, may need Cardiac Anesthesia Evaluation Is > 24 yrs of age, thus requiring care by an FNP PHC APP will determine the need for a face-to-face visit with the ARC and will work with the ARC Admin team to schedule, if necessary. Cardiac Anesthesia Evaluation needed, PHC will initiate evaluation.
KOPH Consult	Review KOPH Patient Selection Criteria Choose if uncertain if criteria met for care at KOPH
ASC Consult	Review ASC Patient Selection Guidelines Job Aid Choose if there are any clinical concerns that require review with medical director or designee as outlined in job aid
ASC Candidate	Meets criteria ASC Patient Selection Guidelines Job Aid

Reference

CMS Manual System

©2024 by Children's Hospital of Philadelphia, all rights reserved.
Use of this site is subject to the Terms of Use.

The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.