E-mail Instructions to Decrease Same Day Surgery Cancellations
Abstract
Same day cancellations on the day of the procedure are associated with poor quality of
care, lower patient satisfaction, and higher healthcare costs. Cancellations are often the result of
NPO (nil per os or nothing by mouth) violations, missed preoperative instructions, and patient
illness. This quality improvement project explored email preoperative instructions as a means to
decrease surgical cancellations on the day of the procedure.
Methods
Design and Setting
This quality improvement project was implemented in a large pediatric facility using
convenience sampling to evaluate the effectiveness of emailed preoperative instructions along
with preoperative phone calls to decrease same day surgery cancellations. The project was
implemented in four outpatient surgical services.
Implementation and Data Analysis
Retrospective and prospective data were gathered from the electronic medical records.
Pre-intervention data was gathered from 6/12/2017 to 9/15/2017. The emailed preoperative
instructions were implemented in four surgical services over a 13-week period. Implementation
and post-intervention data were gathered from 10/15/2017 to 1/12/2018.
Data collected was analyzed using SPSS. The chi-square and Mann-Whitney U test were
used to measure the statistical significance of emailed preoperative instructions to decrease
surgical cancellations.
Results
Although not statistically significant, results yielded clinical significance. In most
instances, there were fewer same day cancellations when parents/guardians received emailed
preoperative instructions.
Conclusion
Emailed preoperative instructions enhances medical communication and provides parents
and guardians a retrievable reference of NPO (nil per os or nothing by mouth) guidelines, patient
illness considerations, medication recommendations, and arrival times.