You Can’t Afford to Have a Cancellation.
We have all experienced it at one time or another: waiting on a patient to show, only to have a no show. Or the patient comes in only to admit they ate breakfast and they all say the same thing, “No one told me I couldn’t eat.” The reasons for same-day cancellations may vary but the consequences are all the same - wasted time, resources, and productivity. With even 24 hours notice, time can be filled with other cases or consults, even scheduling a meeting or having a well-deserved short day allowing some rest. As an experienced CRNA, I have seen many a patient cancelled on the day of surgery, creating havoc with operating room and office schedules. Through assessing those situations and digging deeper into the reasons for the cancellations and ways to avoid them, I have been able to work with multiple offices to optimize their scheduling and safely but efficiently work surgeries into your busy office practice. The bottom line is with a busy practice you simply cannot afford to have a cancellation put a hole in your schedule.
Reasons for cancellations vary, however the big three for ambulatory surgeries are:
inappropriate NPO status,
no show due to patient being unaware of correct time or place of scheduled surgery
patients not having a ride home after receiving anesthesia.
Other reasons will always come up, but those three are the most common and most easily avoided.
So What’s the Solution?
The remedy for assuring your practice minimizes same day cancellations is easy, efficient, and takes little extra time. Two phone calls prior to surgery day has been shown to decrease cancellations.
Check-In #1: 1-2 weeks prior to surgery day
This is the time to confirm surgery time and place, what to expect after surgery, NPO guidelines, and verifying the patient has a ride home by a responsible party.
Check-In #2: 2 days prior to surgery day
In the days right before surgery, you need to re-verify that the client has the info you gave in Check-In #1, that they remember it and are prepared. Ensure nothing important was missed by having a call script and checklist so that every patient is given the same correct information.
Checklists used preoperatively have also been shown to increase patient satisfaction. As a final check against error, create and regularly review a call log to make sure every patient has been contacted and given appropriate information. Within 3 months of implementing a call log and script protocol, cancellations at a surgery center were decreased by roughly 50% - from 16.8% to 8.8% (1).
Although the interventions seem simple, they are not easy. An in-depth look at your practice, patient demographics, surgery schedule, and reasons for current cancellations need to be done. After this assessment the necessary changes can be made to improve your practice’s optimization on surgery days.
Rest Easy…We Can Help.
Lanners Anesthesia is uniquely capable of assessing and implementing the changes your practice needs to run more efficiently and decrease same day cancellations. We offer consultative services for efficiency and optimization and can help you find the pre-operative care plan that works best for your practice and your patients. Our CRNAs are also able to take over the entire pre-surgery protocol from you if you would prefer to off-load this task instead of absorb it onto your employees. Contact us today to find out more about how we can help you lower your cancellation rate and streamline the pre-operative process for your practice.
(1) Lee CM, Rodgers C, Oh AK, Muckler VC. Reducing surgery cancellations at a pediatric ambulatory surgery center. AORN J 2017;105:384-391.