An18-month collaboration between ambulatory surgical facilities (ASFs) in northeast Pennsylvania and the Pennsylvania Patient Safety Authority has resulted in decreased day-of-surgery (DOS) cancellations by using a nurse-driven preoperative screening and assessment.
According to published results, the ASFs achieved a 9.7 percent reduction in their DOS cancellation rate, from 29.6 DOS cancellations per 1,000 completed procedures pre-intervention to 26.8 DOS cancellations per 1,000 completed procedures post-intervention.
A nurse-driven preoperative screening and assessment is a separate clinical evaluation for patients undergoing same-day surgery, which is used to identify the patients medical, physical and psychosocial needs and risks for developing complications or requiring cancellation of same-day surgery.
From January 2012 through June 2013, the Authority conducted the project with 11 ASFs in the northeast region of Pennsylvania. What the pilot found was that no-show cancellation rates were 120 percent higher in patients who did not have a preoperative screening and assessment done compared to patients who were screened preoperatively during the post-intervention period.
In addition, transportation-related and protocol-related day-of-surgery cancellations decreased by 28.5 percent and 22.4 percent, respectively, in patients who received a preoperative screening and assessment using a standardized checklist.
No shows on the day-of-surgery drop 10 to 15 percent if a preoperative screening and assessment is performed. That number increases 30 to 50 percent if a preoperative screening and assessment is not done prior to the day of surgery, said Lea Anne Gardner, PhD, RN, senior patient safety analyst for the Pennsylvania Patient Safety Authority, in a written statement. Selecting appropriate patients for same-day-surgery through the implementation of these interventions can improve patient safety by identifying patients suited for outpatient surgery or procedures, reduce disruptions or delays in the surgery schedule and increase patient accountability.
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