Nancy Chu-Widjaja

Preoperative Instructions Through Reminder Tools: A Quality Improvement Project to Reduce Preventable Last-minute Cancellations in the Endoscopy Suite

BACKGROUND: Clear communication on preoperative instructions (PI) is crucial to ensure patient safety. The failure to provide clear communication could cause delays or cancellations. Last-minute cancellations could disrupt organizational workflow resulting in increased wasted resources, costs, and revenue loss.

AIM: To evaluate the impact of early reminder tools on preventable last-minute cancellations and patient adherence to PI.

METHOD: An improvement project was implemented at the Endoscopy Suite of a cancer hospital in the northeast United States with over 7,000 outpatient procedures annually. Patients routinely receive a call from the prep nurse team three days before the day of surgery (DOS). The project implemented additional call and email with notifications from the patient portal application as early interventions to remind patients of their PI two to three weeks before DOS.

RESULTS: The project observed a slight difference in last-minute cancellations during the pre-intervention, call, and email reminders phases (16.4%, 14.6%, and 15.7%). However, there were fewer preventable cancellations in the call and email reminders phases compared to the pre-intervention phase by 9.3% & 14.1%, respectively. The interventions also significantly reduced unawareness/forgetfulness as cancellation reasons related to patient adherence to PI.

CONCLUSION: In this project, early reminder tools were helpful in reducing last-minute cancellations. The reminder tools reduced preventable cancellations, which were related to patient adherence to PI. The reminder tools facilitated the early cancellation and rescheduling process to maximize operating room utilization.

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