It is no secret the negative impact cancelled surgeries have on a facility’s bottom line. Studies have shown that hospitals lose millions in direct and indirect costs. Reasons may vary why a patient decided to cancel, but research projects have indicated that a visit at a pre-anesthesia testing/screening (PAT/PAS) clinic will reduce the frequency of cancellations.
In the March 2013 issue of Anesthesiology News, the consolidation of the preoperative process was explored at the University of Nebraska Medical Center (NMC) in Omaha. Without a standardized, streamlined PAT clinic, the facility suffered from a high rate of case delays (50% of first time cases) and cancellations (2.6% within 24 hours of surgery). Original presurgical screening was so disorganized that a majority of patients received their first full clinical screening the day of the procedure.
Once the involved stakeholders decided change was necessary, they developed a unique, hybrid approach for pre-op assessment. Instead of requiring all patients to visit the facility’s new PAS clinic, patients were screened by phone. If the nursing staff determined that a patient fell under certain guidelines – the patient was high-risk or the procedure was invasive, for example – the patient was asked to visit the PAS clinic. Once at the facility, the patient was then put through the standard battery of tests and saw all necessary individuals, eliminating multiple visits to see multiple people.
The results of the PAS clinic were inarguable.First-case delays fell to 20%, down from originally 50%, and case cancellations were cut in half, to 1.6%. The clinic was also able to screen 90% of surgical patients by phone, 70% of which didn’t require an on-site visit to the PAS clinic. Other benefits included an increase OR utilization, decrease in staffing cost, and an improvement in surgeon and administration satisfaction.
To read more about the importance of anesthesia during the entire perioperative process, download “Creating a Perioperative Partnership for Operating Room Managers.”