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Implementation of electronic messaging protocol for pediatric urology preoperative scheduling: A pilot study
Morgan E Schubbe1, Jeffrey Edman1, Julie Williams2
1University of Iowa Hospitals and Clinics, Department of Urology, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Insights
Electronic messaging (EM) effectively prepares pediatric urology patients for surgery, showing high satisfaction and cost savings. This method streamlines preoperative instructions without increasing delays or cancellations.
Area of Science:
- Urology
- Healthcare Management
- Patient Communication
Background:
- Optimizing surgical preparation is crucial for healthcare organizations.
- Electronic messaging (EM) offers a potential solution for streamlining preoperative processes.
- This study evaluates the early use of EM for preoperative instructions in pediatric urology.
Purpose of the Study:
- To assess the effectiveness of EM in preparing pediatric urology patients for surgery.
- To compare EM with traditional nurse phone calls (NPC) for preoperative instruction.
- To evaluate patient/parent satisfaction and healthcare system resource utilization.
Main Methods:
- A 6-week pilot program compared EM with NPC for preoperative instructions.
- The same information was delivered through both methods.
- Data collected included system costs, time, resources, and patient/parent satisfaction.
Main Results:
- EM and NPC groups had similar case cancellation rates (6.67% vs. 10.55%).
- EM resulted in fewer required follow-up calls (24% vs. 50%) and high patient recommendation (94%).
- EM demonstrated significant cost savings ($81.82/day, $21,273.20/year) compared to NPC.
Conclusions:
- EM is effective for communicating preoperative information to pediatric urology patients.
- EM leads to high patient satisfaction, cost savings, and efficient use of nursing time.
- Further research is needed to refine the role of perioperative EM.
Introduction:
Preparing patients for surgery is a task healthcare organizations strive to optimize. Electronic messaging (EM) provides an opportunity for streamlining components of this arduous process. Our study aims to evaluate our early experience in utilizing EM to provide preoperative information to pediatric urology patients.
Objective:
To assess the effectiveness of EM in preparing patients for pediatric urologic surgery.
Study Design:
This study compared a 6-week pilot program of EM (Figure 1) with traditional nurse phone calls (NPC) in preoperative instruction of pediatric urology patients. The same preoperative instructional information was provided via either source. Data collected included time and resources used by the healthcare system and patient/parent satisfaction.
Results:
The EM group included 98 patients, while the NPC group included 212 patients. Case cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z = -1.137, p = 0.25). There were 4 EM-related operating room delays with an average case delay of 31.5 min (5-60 min). Twenty-four (24%) EM patients/families required secondary phone calls, while 106 (50%) NPC required a follow up phone call (p < 0.01). 94% of EM participants recommended EM for future perioperative instructions. Accounting for the average case volume within our entire children's hospital, the average total daily cost for EM is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based upon average total case volume at our institution.
Discussion:
In our initial experience, EM effectively communicates the necessary preoperative information to patients and/or families undergoing pediatric urology surgery. Our results demonstrate low case cancellation and delay rates and high patient/family satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM. A great benefit of EM was the increased time it provided for nurses to perform other patient care duties, which is important given our current nationwide nursing shortage. Limitations of the study included a narrow scope assessing only pediatric urology patients as well as a short study period. Further studies will further define and refine the role of perioperative EM.
Conclusion:
Changing to an EM system for preoperative instructions in the pediatric urology population met with a high degree of patient satisfaction and decreased costs for healthcare systems without increasing case delay or cancellation rates.
