Decreasing Endoscopy No-Shows Using a Lean Improvement Framework

Finn, Raymond T.; Lloyd, Benjamin; Patel, Yuval A.; Allen, J. T.; Cornejo, Jennifer; Davis, Andrea; McIntosh, Thasha; Ferguson, Stephanie; Sims, Kellie J.; Sudaj, Shawn; Taheri, Javad; Burr, Nicholas A.; Provenzale, Dawn; Gellad, Ziad F.

doi:10.1016/j.cgh.2019.02.002

Cited by 4 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unlike outpatient clinics where an appointment spot vacated by cancellation or no-show can potentially be filled at the last minute, upper endoscopies and colonoscopies require procedure preparation and someone to accompany the patient to the clinic (Finn et al, 2019). When patients cancel on the day of their appointment, other patients are prevented from receiving needed treatments, resulting in two patients missing the needed procedure.…”

Section: Same-day Cancellations Effectsmentioning

confidence: 99%

Moving the Needle on Patient Cancellations Through Mobile Integration

Smith

Ashcraft

2022

Gastroenterology Nursing

View full text Add to dashboard Cite

c olorectal cancer (cRc) is the second leading cause of cancer-related deaths in the United States and ranks in the top three most diagnosed cancers in both men and women (American Gastroenterological Association [AGA], 2022). Early detection and removal of localized adenocarcinoma and adenomatous polyps reduce colon cancer mortality by 53% (AGA, 2022). A quality improvement (QI) project was implemented in August 2020 to reduce the rate of same-day colonoscopy procedure cancellations at a hospital located in Houston, Texas. The goal was to determine whether implementing the Annie mobile application, a short message service (SMS) text messaging application that sends a series of timed detailed text about colonoscopy prep instructions, would increase nothing by mouth (NPO) compliance.Efficiency is essential in managing large volumes of patients requiring colonoscopies, which is considered the gold standard in detecting cancerous polyps. There is always a demand for a system that can show efficiency, ease, affordability, and better return on investment. Incorporating one modest adjustment in mobile integration of care held the potential to save millions of dollars for a facility managing a large number of patients daily. Local ProblemThe need to improve same-day patient cancellation rates was identified at a large high-volume gastroenterology (GI) clinic with the highest same-day cancellation rate in the healthcare system. currently, the project site has a 24% cancellation, 21% above the AGA benchmark recommendation of less than 3% (AGA,

show abstract

Section: Same-day Cancellations Effectsmentioning

confidence: 99%

Moving the Needle on Patient Cancellations Through Mobile Integration

Smith

Ashcraft

2022

Gastroenterology Nursing

View full text Add to dashboard Cite

show abstract

“…A QI intervention in Australia resulted in a dramatic and sustained improvement in variceal eradication rates after hiring of a dedicated nurse to coordinate patient follow-up after variceal bleeding (8). Furthermore, a recent study in a Veterans Affairs endoscopy unit identified interventions focused on improving patient education and streamlining the process of canceling and rescheduling procedures as the most effective at decreasing no-shows and late cancellations (9). These studies in combination with our findings suggest that QI efforts must extend beyond educational interventions alone to be effective.…”

Section: Preintervention Datamentioning

confidence: 99%

A Quality Improvement Initiative Results in Improved Rates of Timely Postvariceal Bleeding Surveillance Endoscopy

et al. 2020

View full text Add to dashboard Cite

We performed a study to assess the effects of a quality improvement (QI) initiative on the rates of postvariceal bleeding surveillance upper endoscopy (EGD). METHODS:We identified patients with cirrhosis hospitalized with variceal bleeding and assessed the rates of timely (£4 weeks) EGD before and after a QI initiative. RESULTS:Preintervention: 16% (5 of 32) of patients underwent timely surveillance EGD. We developed a standardized ordering template for gastroenterology fellows and reserved postvariceal EGD scheduling slots. Postintervention: 43% (12 of 28) of patients underwent timely surveillance EGD. DISCUSSION:A QI intervention was associated with a 27% absolute increase in timely surveillance EGDs.

show abstract

“…Escort's schedules must be coordinated and time off from work arranged. Cancelling procedures due to lack of escorts can lead to inefficiencies and gaps in the surgical schedule [18]. More troublesome and difficult to quantify are the delays in medical care for the patient, in some cases indefinitely.…”

Section: Introductionmentioning

confidence: 99%

Discharging select patients without an escort after ambulatory anesthesia: identifying return to baseline function

Walsh

2021

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of reviewThe current standard of care requires ambulatory surgical patients to have an escort for discharge. Recent studies have started to challenge this dogma. Modern ultrashort acting anesthetics have minimal psychomotor effects after a couple of hours. Driving simulator performance and psychomotor testing return to baseline as soon as 1 h following propofol sedation. Recent findingsTwo recent reports of actual experience with thousands of patients found no increase in complications in patients who were discharged without escort or drove themselves from a sedation center. These studies suggest discharge without escort may be safe in select patients but a method to identify appropriate patients remains undefined. SummaryA reliable test to document return of function might allow safe discharge without an escort. Currently, there is intense interest in developing reliable, inexpensive, easy to administer psychomotor function testing to improve workplace safety and legally define the effects of drugs on driving impairment. Future studies may be able to adapt this technology and develop a validated test for residual anesthetic impairment.

show abstract

Decreasing Endoscopy No-Shows Using a Lean Improvement Framework

Cited by 4 publications

References 11 publications

Moving the Needle on Patient Cancellations Through Mobile Integration

Moving the Needle on Patient Cancellations Through Mobile Integration

A Quality Improvement Initiative Results in Improved Rates of Timely Postvariceal Bleeding Surveillance Endoscopy

Discharging select patients without an escort after ambulatory anesthesia: identifying return to baseline function

Contact Info

Product

Resources

About