Patient and Parent Engagement in Preoperative Telephone Call for Efficiency in Elective Surgery

Abstract

Introducton Late starts in the operating room (OR) create inefficiency, wasting resources including time, labor, and money. The purpose of this project was to determine how a modified preoperative telephone call could impact first-case start times, using Pareto's theory of efficiency and Homans's social exchange theory to bring the patient in as a partner in care. Method This preintervention–postintervention project compared telephone call methodologies and its effect on first-case start time. Previously, the OR clerk called the patient/parent and read a list of instructions. For this study, the clerk was retrained by the researcher to involve the patient/parent in the dialogue. Instead of “Be sure to do all prescribed tests ordered by physician before you come,” the language was “Did your doctor give you any instructions for Billy? Tell me about it? What have you done already?” The control group was measurement of late starts for 120 cases before the intervention and matched to 120 cases after the intervention. Results Statistical analysis showed a 7.5% improvement in the number of late start cases, from 31/120 to 22/120. The number of late minutes decreased from 500 to 171 (p = .010). Discussion As each hour in the OR is billed at approximately $3,000, implementation of this modified preoperative telephone call significantly improved operational efficiency with $0 cost to the organization. The number of late cases was decreased, and the time saved was surprisingly compelling.