Outpatient Surgery Magazine - Subscribers

No More Empty Beds - Outpatient Surgery Magazine - February 2020

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1208631

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Page 28 of 114

they trusted with their lives. Those are avoidable outcomes because most case cancellations are entirely preventable and often unnecessary. They should be consid- ered never events, just like a medication error or a wrong-site proce- dure. You need to identify their causes and determine how to solve them. Your ultimate goal is to make sure every surgery goes off as planned. A call for change AORN advises surgical facilities to keep their same-day case cancel- lation rate under 2%. Ours was as high as 4% when we decided to take a critical look at the problem. The rate is now down to 1% thanks to over-the-phone assessments of patients conducted by one of our CRNAs during calls made the day before scheduled cases. When we began investigating why our same-day cancellation rate was too high, we zeroed in on a frequent factor — patients would arrive for their scheduled surgeries, but then be disqualified after the anesthesiologist's pre-op examination. On the day of surgery, your anesthesia providers might be looking at labs that are a week old. In the meantime, they learn the patient's been bleeding, so their hemo- globin level might be very different. It's determined that the patient needs blood before surgery. That's another two or three hours of time your surgeon or your schedule might not have. When we decided to test the effectiveness of day-before-surgery patient assessment phone calls, we took 120 cases and split them evenly into two groups: patients assessed over the phone by a CRNA and patients who were contacted by a peri-op nurse. Our facility usu- ally performs 40 to 60 procedures per day, so this was a good sample size. There were 10 cancellations, a rate of 8.3%, but only two of those cancellations occurred among patients the CRNA called. F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 2 9

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