Learning Objective #1: identify team participation and influence of minimizing incidence and prevalence of skin pressure ulcers within the ambulatory surgical program.

Learning Objective #2: recognize team accountability, responsibility and access to timely evaluations of patient care outcomes.

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Decreasing the incidence and prevalence of pressure skin ulcers is one of Toronto's academic teaching hospital's corporate priority. At present, the Braden scale, a world renowned clinically validated tool, is used in the inpatient areas allowing nurses and other health care providers to predict the risk for patients developing pressure skin ulcers following admission to inpatient areas. However, the first patient contact along the surgical continuum of care is the Pre-admission Unit, which is the focal point for preoperative patient assessment, education, and identification of predicable risk factors, pre-operative team coordination and communication of patient care plan prior to elective surgery. This academic teaching hospital's Integrated Surgical Programs belief is clinical practice and such important preventive measures should start prior to elective admission for surgery and assessment to be continued following transfer to an inpatient area. The purpose of this initiative was to improve quality of patient care provided to surgical patients through the development of a redesigned/reformatted documentation form of the Braden Scale, reflecting the surgical patient's skin assessment initially in the Pre-admission Unit (PAU), Same Day Admission Unit (SAU), Operating Room (OR), Post-Anesthetic Care Unit (PACU), and continued afterwards in the in-patient surgical unit.