What We Do:

The Center for Perioperative Optimization’s goal is to make your surgery as safe and stress free as possible. Our center is part of the Department of Anesthesiology and Critical Care Medicine and is staffed by Attending Anesthesiologists, Resident Anesthesiologists, Nurse Practitioners, and Physician Assistants. Patients are referred to our center by their surgeon’s office based on their past medical history. Our care team at the CPO is committed to ensuring that you are medically prepared for your scheduled surgery with an appropriate anesthesia care plan in place.

We offer two types of appointments at our center depending on your specific needs. During a Preoperative Visit, you will be seen by a Physician Assistant or Nurse practitioner who works with the Anesthesia Team for your evaluation and care planning. Alternatively, if you are scheduled for an Anesthesia Consult, you will be seen by one of our Anesthesia Residents and an Anesthesia Attending physician. Your time with our center will take approximately one hour, which does not include preoperative lab or radiologic testing that you may need.

 

Please bring the following with you for your Preoperative Visit or Anesthesia Consult:

  • Insurance Information and a Photo ID
  • List of your current medications along with dosage and frequency
  • Name and phone number of your Primary Care Physician and any Specialists that you see
  • Copies of any outside testing (i.e. Previous EKG, Stress tests, Echocardiograms, lab/blood tests, etc.)
  • Copy of Advanced Directive and/or Living Will

Please check with your insurance company before coming to your Preoperative Visit or Anesthesia Consult to check if you can have your preoperative testing done at Johns Hopkins. If you cannot have your testing here, you can have your surgeon’s office give you orders for which tests need to be done and get these done at an outside facility (preferably before your Perioperative Visit/Anesthesia Consult date).

Please note, you DO NOT NEED TO FAST for your Preoperative appointment. If you are having any special radiologic procedure scheduled by your surgeon’s office,( i.e. CAT Scan or MRI) it may require fasting so please check with your surgical service.

Medical Evaluation: You will have your vital signs checked by one of our Certified Medical Assistants. Then you will see one of our Physician Assistants or Nurse Practitioners for an Anesthesia focused History and Physical Exam. You will be given detailed instructions about when and where to report for your surgery along with directions as to which medications to take the morning of surgery. We realize this is an extremely stressful time for you and we encourage you to write down any questions you may have and we will do our best to answer them. We ask that you bring no more than 2 visitors to accompany you inside the exam room to reduce distractions during your visit.

Preoperative Testing: You may need lab work, EKG and /or Chest X-ray after you preoperative appointment, in preparation for your surgery. This will be determined by the surgeon and the provider that is evaluating you the day of your Preoperative appointment. If you have had any of these tests done recently outside of Hopkins, please bring the results with you the day of your Pre-op appointment. Our laboratory, Express Testing, is located on the first floor of the Outpatient Center next to the Pharmacy. They draw blood, collect urine specimens and perform EKG’s.  Our Radiology Department is located on the fourth floor directly across from the elevator. Both departments are open Monday through Friday from 7:30am – 5:30pm, except holidays.

If you are scheduled to be admitted after your surgery, you will be given an opportunity to see an Admitting Representative at our clinic. The representative will confirm your insurance for your admission and reserve a hospital bed for you. If you have a copy of your Advanced Directive or Living Will, the Admitting Representative  will ensure that this is included with your surgical information.

Before your surgery, you will be given NPO instructions. “NPO” is a Latin abbreviation for “nothing by mouth.” Food and drink taken before anesthesia can cause problems such as choking or vomiting. There are a few rules about eating and drinking that can prevent these problems. If you have been given specific instructions from your surgeon regarding consumption of liquids preoperatively, then please follow those instructions. 

  • NO solid foods, non-clear liquids including milk, milk products, creamers, gum, mints, or candy after midnight the night prior to your surgery.
  • We encourage consumption of CLEAR LIQUIDS after midnight the night before your surgery. Acceptable Clear Liquids are listed below.
  • If you are scheduled to arrive before 10:00am: You may drink clear liquids up to two (2) hours prior to the time of your surgery. Your last clear liquid beverage should not be more than eight (8) ounces, consumed within the last hour you are allowed to have clear liquids. Prior to this you are allowed unlimited clear liquids.
  • If you are scheduled to arrive after 10:00am: You may drink clear liquids up to four (4) hours prior to the time of your surgery (2 hours before you are to report to the hospital). Your last clear liquid beverage should not be more than eight (8) ounces, consumed within the last hour you are allowed to have clear liquids. Prior to this, you are allowed unlimited clear liquids.
ACCEPTABLE CLEAR LIQUIDS NO!
Water
Gatorade/Powerade sports drinks
(avoid red if having colorectal procedure or surgery)
Apple juice (no pulp)
Black coffee with or without sugar
Tea with or without sugar
Milk
Cream or other milk-based products
Coffee with cream/milk
Tea with cream/milk
Orange juice
Any juices with pulp
Tang or any powder-based drink

Full Adult NPO Guidelines: Arabic, English, FrenchSpanish

Full Pediatric NPO Guidelines: Arabic, English, French, Spanish

*These guidelines are in Adope PDF format – please click here to downlad a free version of the software.

The CPO is located in the Johns Hopkins Outpatient Center on the East Baltimore Medical Campus. Click here for map and directions.

Parking

For your convenience, parking is located next to the Outpatient Center in the McElderry Garage. The entrance to the garage is located off of North Caroline Street.

JHOCCampusMap

Food and Beverage Availability

There are several dining options that are located in the Outpatient Center. The Women’s Board Coffee Shop is on the first floor of the Outpatient Center and is open Monday through Friday, 7:30AM – 3:30PM. The 601 Grille is on the second floor of the Outpatient Center and is open Monday through Friday, 6:00AM-2:30PM.

Internet Access

If you have a mobile device with you, free wireless access is available as “JHGuestnet.” Mobile devices are allowed in the waiting room but should be powered off once inside the exam room.

CPO Attending Physicians

Jerry Stonemetz, MD, Director
Kristin Cheung, MD
William Merritt, MD, MBA
Neal Sakima, MD
Tracey Smith-Stierer, MD

CPO Advance Practice Providers

Kristen Barnett, MSN, AGPCNP, NP-C
Monica Bryant, PA-C
Nancy Crawford, PA-C
Mary Drymala, PA-C
William Fleming PA-C (Bill)
Lynn Hause, PA-C
Ersilia Healy, CRNP
Teresa Krosnick, PA-C
Lynn Nauman, PA-C
Meredith Piccinini, NP
Carol Sheahan, ANP-BC
Deborah Smith, MSN, FNP-BC
Susan Wolf, PA-C, MPAS, MMS
Crystal Zelinske, PA-C, MMS

Please see our CPO Preoperative Roadmap – a summary for surgeons and other providers who require anesthesia services guideance. The Roadmap highlights the processes by which we at the CPO utilize to faciltate the best possible care for your patients and to ensure your patients are not cancelled or delayed on the day of surgery. Please be sure to utilize the Patient Evaluation Screening Form (Appendix A) with your patients to help determined their CPO scheduling needs.