Date of Graduation

Summer 8-9-2024

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

Sara Horton-Deutsch, PhD, RN, FAAN, ANEF, Caritas Coach & Leader

Second Advisor

Liesel Buchner DNP, MSN, RN, CNL

Third Advisor

Dave Ainsworth DNP, MSN, RN, CNL

Abstract

Problem: The increased frequency of same-day surgical cancellations affects patient care quality, causes loss of expenses for patients and facilities, and causes non-compliance with block utilization against regional standards.

Context: A collaborative effort was undertaken to reduce same-day case cancellations in the Ambulatory Surgery Unit (ASU). Patients received preoperative instructions 24 hours before surgery through email or phone call. Data collection revealed that the common causes of same-day cancellations were avoidable reasons (not NPO, patient ill, request for another schedule, no ride), indicating the need for improvement in delivering preoperative phone calls.

Interventions: This included educating preoperative nurses, creating a standard script, reshaping staff assignments, and implementing 72-hour pre-operative phone calls.

Measures: ASU management collected same-day case cancellation data for the project. The data for total case cancelations from January 2024 to June 2024 was taken from Health Connect. TPMG consulting services gives a monthly block utilization report to perioperative leadership.

Results: Same-day cancellations decreased by 16% from January to June 2024. The top three reasons for cancellations were patient illness, not medically cleared, and not NPO. Block utilization remained at 80% after project implementation.

Conclusion: Implementing 72-hour preop phone calls reduced the occurrence of same-day cancellations, but the top reasons remain the same. A recommendation is to try providing preoperative instructions through 24-hour phone calls, which will help reduce same-day cancellations for avoidable reasons.

Keywords: same-day case cancellations, avoidable reasons, block utilization, preop phone calls

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