Implementation of Electronic Messaging Protocol for Pediatric Urology Preoperative Scheduling: A Pilot Study
Morgan Schubbe, MD, Julie Williams, BSN, Christopher Cooper, MD, Gina Lockwood, MD, Douglas Storm, MD.
University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
BACKGROUND: Electronic messaging (EM) is commonly utilized to remind patients of clinic visits but is not routinely used for surgical patients. Perioperative communication requires transmission and understanding of complex data. We implemented an EM system to deliver preoperative information to pediatric urology patients. We reviewed our early experience with this technology. METHODS: 6-week pilot was performed July - September 2019. All patients received EM via text or email 3 business days before surgery conveying arrival time, parking and check-in location, and NPO instructions. Confirmation was by direct reply to the message. Metrics included case cancelations, delays, and secondary phone calls. Case cancelation rate was compared to 3 months prior when all preoperative information was conveyed by a nurse (RN) via telephone. Patient satisfaction was also assessed. RESULTS: 100 and 195 patients were included in the EM and RN call (NPC) groups, respectively. Case cancelation rate was 7% in the EM vs. 14% in the NPC cohort (p=0.13). There were 4 EM related delays resulting in average of 31.5 minutes (5-60 minutes) of operating room delay. 24 secondary phone calls were required for clarification. 94% of EM participants recommended EM for future perioperative instructions. Based on average operating room volume, estimated cost across surgical services for EM is $3.30/day vs. $87.78 RN wage dollars/day and would alleviate an average of 4 hours RN time. CONCLUSIONS:
An EM system is an accurate and cost-effective way to communicate preoperative instructions and does not affect case cancelation rate. Further studies will evaluate implementation across all surgical services.
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