Evaluation of the Efficacy of the ECT Patients Preparation Checklist in Reducing the Cancellation Rate in an Academic Hospital

Abstract

Background: Electroconvulsive therapy (ECT) is a vital treatment strategy for psychiatric patients, and cancellation of the procedure negatively impacts the recovery process. However, it may happen due to the lack of optimal conditions at admission. Methods: This retrospective study occurred at Shafa Hospital, an academic center affiliated with the Guilan University of Medical Sciences (GUMS). The ECT anesthesia team developed an ECT patient preparation checklist, which was shared with psychiatrists. The rate and some related factors of case cancellation were compared between the two years before presenting the checklist, from May 2019 to May 2020, and the next year, from June 2020 to May 2021. The patients’ files were reviewed, and the required information was documented. Results: One hundred fifty-one cancellations were recorded during the two years of study, 82 cases in the first year and 69 in the second year. The most common reason for the cancellation was inadequate consultations followed by abnormal lab tests. In comparing the number of cancellations between the two years, before and after the checklist was provided, no significant difference was observed in terms of age (P = 0.288), gender (P = 0.24), psychiatric disorder (P = 0.399), and the number of ECT sessions (P = 0.36). However, the number of cancellations due to incomplete consultation significantly decreased after developing the checklist (P = 0.049), while unstable hemodynamics and changing patients’ conditions on an intended day also increased (P = 0.024). Residency visits did not significantly affect the number of cancellations over 2 years (P = 0.139). Conclusions: This study concluded that preparing ECT patients according to the checklist led to better conditions and fewer cancellations. However, preventable causes still exist.