b. for outpatients only, in lieu of an H & P, a Hospital department specific pre-procedure evaluation which:
( 1) includes a Medical Staff member pre-sedation assessment and plan, and
( 2) has been approved by the Medical Staff Executive Committee following input from the appropriate Medical Staff Departments and / or Sections.
B. 3.
An Emergency Department( ED) Medical Staff note containing the required H & P elements noted above may be considered an H & P for the purposes of procedures performed while the patient is in the ED. When a patient is transferred or admitted to another area of the Hospital, another H & P must be performed and documented by the responsible Medical Staff member.
B. 4.
For the purposes of these Rules and Regulations, anesthesia services include the following:
a. general anesthesia; b. regional anesthesia; c. monitored anesthesia care( MAC); and d. deep( level 5) sedation.
1. An H & P update should, at a minimum, include the following: a statement that the H & P was reviewed, a statement that the patient was interviewed, a statement describing pertinent changes or their absence, the date and time of the update, and the signature of the responsible Medical Staff Member.
2. Responsibility for updating the H & P prior to a surgery or procedure:
( i) If the surgery or procedure itself requires an H & P, a written update documented in a progress note by a licensed practitioner who is credentialed and privileged by the Medical Staff to perform H & Ps is required.
( ii) If an H & P is required for a surgery or procedure solely because the patient is receiving anesthesia services( i. e., outpatient MRI, pediatric dental, etc.), the responsible
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