Using Nurse‐to‐Patient Telephone Calls to Reduce Day‐of‐Surgery Cancellations

Abstract

Day-of-surgery cancellations are costly and frustrating for both the patient and the health care team. This is especially true in ambulatory surgical centers where it can be difficult to schedule a replacement procedure on short notice. Preoperative nurses at the University of North Carolina Health Care ambulatory surgical center were able to decrease the daily cancellation rate by 53%, increase patient satisfaction scores, and increase OR use by targeting three main reasons for cancellations during a preoperative telephone call. A nurse calls each patient three business days before the scheduled surgery and uses a script to communicate important preoperative information and to address any questions or concerns. The nurse then reports any new information or concerns he or she has learned from the telephone call to the scheduling clinic, anesthesia team, or the surgeon. These calls have resulted in major decreases in cancellations related to no shows, NPO requirements, and lack of a responsible adult present to drive the patient home.

The impact of a structured preoperative protocol on day of surgery cancellations

“…Previous studies have reported a significant decrease in total DOS cancellation rates after implementing preoperative interventions or remodelling preoperative care processes. However, the results are not easily comparable to ours, as the definitions for DOS cancellations vary between studies (Boudreau & Gibson, ; Deng et al., ; Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ) and for example the three category classification (patient, physician, hospital) presented by Tung, Dexter, Jakubczyk, and Glick () would have given too limited information for our study purposes (Dexter et al., ; Tung et al., ). Other studies are also based on limited patient groups (Boudreau & Gibson, ; Deng et al., ; Higson & Finlay, ) or were conducted in substantially smaller hospitals than in this study (Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ; Siragusa et al., ).…”

“…It has been stated that the success of a preoperative process can be well monitored by last‐minute cancellations (Verma et al., ). Several comparative studies presented positive outcomes of interventions carried out in the preoperative process to reduce cancellations (Bathala et al., ; Boudreau & Gibson, ; Deng et al., ; Gheysari et al., ; Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ; Siragusa et al., ) (Table ). To the best of our knowledge, this is the first study to evaluate the impact of implementing an evidence‐based and structured preoperative protocol in a university hospital with all operative specialties included while also searching for meaningful factors in organising preoperative care to reduce day of cancellations.…”

Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China

“…According to the "Funding Regulation on the New Cooperative Medical Scheme" published by the Ministry of Finance and Ministry of Health [28], surplus funds at the end of the year should not exceed 15% of revenue, and the cumulative surplus should be remain less than 25%. During the initial phases of implementation, many NCMS management teams were concerned about exhausting annual revenues and worked vigorously to build reserves.…”

Day surgery in a teaching hospital: identifying barriers to productivity

“…Recognising that maximum efficacy of day surgery units requires the minimization of patient non-attendances, many initiatives have been described including postal questionnaires [24] , telephone call screening [25] and telephone reminders.…”