Feature May 5, 2021 John Bernot, MD

5‑star surgeons deserve 5‑star patients: Coaching your way to fewer no‑shows and improved outcomes

Learn how to increase pre-op task adherence for improved patient outcomes and reduce same day cancellations and no-shows.

A surgeon’s reputation is only as good as their patient outcomes. And especially in competitive markets, an orthopedic surgeon’s reputation is everything. 

Pre-op task adherence, or lack thereof, can lead to poor patient outcomes and higher rates of same-day cancellations.  

A study found that same-day cancellation of an orthopaedic surgery can cost a facility $7,178.1

Coaching your patients to follow pre-op instructions is an opportunity for improved outcomes and lower no-show rates that you can’t afford to ignore. 

What are the top reasons surgeries are cancelled at the last minute?

The following are the top reasons for same-day cancellations and no-shows:

  1. Medication protocols not followed. If a patient did not stop taking their medication at the right time, it’s unsafe to proceed with the surgery. 
  2. Comorbidity of medical conditions such as high blood sugar. High blood sugar is associated with poor incision healing and increases the likelihood of infection. Based on the patient’s history, canceling the surgery and rescheduling for a later date may be necessary.
  3. Cold feet and anxiety. Fear of the unknown and uncertainty about the recovery process often leads to no-shows on surgery day. 
  4. Transportation and logistics. Not all your patients have access to a car or know how to find a surgery center they’ve never visited.

Tips for improving pre-op task adherence 

While the issues above may seem unrelated, bi-directional communication between the patient and their care team can address each. Here’s how: 

  1. Deliver the right information at the right time via the right mode of communication. If you want a patient to stop taking their medication two days before surgery, send them a reminder text the night before they should stop taking it. 
  2. Help them understand why. A patient scheduled for knee replacement surgery might not understand why they need to pay strict attention to controlling their diabetes before and after the surgery. Tell them.
  3. Calm their fears with clear directions and patient stories. Letting patients know what to expect after surgery and how people similar to them have improved their quality of life can be all the reassurance and motivation they need.  
  4. Identify roadblocks early. If your patients can communicate with your staff  that they don’t know where the surgery center is located or that they don’t have a ride on the day of the surgery, you can remove that barrier by providing maps and community transportation resources.

Informed patients are better patients and much more likely to adhere to the pre-op instructions you provide. 

Realizing improved outcomes is a win-win 

Let’s face it, orthopedic surgeons aren’t known for spending time to reassure anxious patients or helping them connect the dots between a hip replacement and other medical conditions.

Enter the virtual perioperative assistant. She delivers the right information at the right time customized for your patients’ specific medical conditions. 

Coaching your patients to follow your instructions is a win-win: Your patients realize better health outcomes while your practice avoids the revenue loss of high no-show rates and same-day cancellations. 

Not to mention, the boost to your reputation for delivering better patient outcomes. 

What are you waiting for? 

Learn how to optimize the pre-op patient experience to overcome the challenges that often result in same-day cancellations and patient no-shows.  

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Bravado Health


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  1. The Financial Burden of Cancelled Surgeries: Implications for Performance Improvement. American Society of Anesthesiologists' Practice Management Conference.