Feature April 20, 2022 John Bernot, MD

Executive Brief: The high cost of low task adherence for surgical and non-surgical procedures

Here are 6 practical tips to avoid the high cost of same-day cancellations and no-shows.

smiling patient with nurse

For busy outpatient surgical centers and practices, same-day cancellations and no-shows for orthopaedic procedures and preventative care screenings are the norm. 

The COVID-19 pandemic only exacerbated this already challenging issue. According to the AMA1, among people who reported needing care during 2020: 

  • 60% with a scheduled elective surgical procedure missed it
  • 58% missed preventative care appointments
  • 50% missed general medical care

While a few same-day cancellations and no-shows are unavoidable, your organization can take steps to reduce them with a dynamic digital health platform that: 

  • Identifies social determinants of health (SDOH) factors that impact the patient journey
  • Manages patients’ expectations to help reduce anxiety
  • Increases patient activation in the days leading up to a procedure

The long-term costs of patient no-shows

Beyond the immediate financial impact of same-day cancellations and appointment no-shows, low task adherence can have a myriad of trickle-down effects as well, including: 

  • Poor patient outcomes for those missing critical preventative health screenings
  • Increased administrative burden on staff to reschedule appointments
  • Lowered patient satisfaction scores as more individuals are unable to get appointments in their desired timeframe
  • Higher rates of clinician and staff burnout
  • Inefficient resource utilization in an already strained healthcare system

Why patient activation is essential

Preventative screenings, including mammograms and colonoscopies, rely at least in part on some level of patient engagement.

At 6.9%, mammography has the highest no-show rate2 of any radiology specialty and one study found colonoscopy no-shows are as high as 40%.3

Lacking urgency, preventative screenings easily go unscheduled—especially if they seem uncomfortable. 

In addition, colonoscopies require extensive and complicated prep on the part of the patient, which further increases the likelihood of same-day cancellations.

Research using the patient activation measure (PAM), a quantifiable scale4 of often difficult-to-measure patient engagement activities, has found:

  • Patients with higher activation scores are significantly more likely to have obtained cancer screenings than those with lower PAM scores.5
  • Patients with higher activation scores are strongly related to improvements in a broad range of QOL (quality of life) and health outcomes.6
  • Patients with lower activation scores are associated with healthcare costs up to 21% higher than those with higher activation scores.7

Practical tips for increasing task adherence and preparedness before a procedure

Here are six ways case managers and care teams can increase task adherence before a procedure to reduce the likelihood of no-shows, same-day cancellations, and complications: 

  1. Stagger the delivery of complicated instructions and to-dos so as not to overwhelm patients.
  2. Provide detailed information, including videos, about what to expect before, during, and after their scheduled procedure. 
  3. Enable patients to confirm they have transportation to and from their appointment. 
  4. Send reminders that require patients to check-off tasks and confirm appointments. 
  5. Identify at-risk patients with SDOH factors that may impact care. 
  6. Offer patients the ability to ask questions with two-way patient-provider communication.

Patient engagement for every care journey

From chronic disease management to orthopaedic surgery and preventative health screenings like mammograms and colonoscopies, increasing patient engagement before surgical and non-surgical procedures is critical to overcoming some of your organization’s biggest challenges.

The impact of the high rate of same-day cancellations and no-shows can be far-reaching, and a mitigation strategy is a must in today’s busy healthcare ecosystem. 

Ayva is a dynamic patient engagement platform that simplifies the care journey from preparation to recovery across the spectrum of care. 

Meet Ayva today!

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Shane Andreasen

Bravado Health


Bravado Health Media Line


(561) 805-5935