Overcoming Pre-Surgical Process Complexities for an Improved Patient Journey

By Dr. Gaj Srikanthan

The pre-surgical process can be a complicated but necessary journey for patients. Just as much focus needs to be put into the pre-surgical process as the surgery itself. If patients are unprepared, do not know what to expect, or feel that they were left out of the decision-making process, it can create a negative experience for patients and caregivers alike. Not to mention, a haphazard approach to patient readiness can lead to last minute cancellations or no-shows, which impact the provider’s bottom line. 

When providers understand the current complexities and can effectively create a seamless journey for patients, pre-surgery optimization efforts can improve so that both caregivers and patients have better experiences. There are numerous layers to the pre-surgical process – it’s not just about handing the patient a pamphlet explaining the surgery she will soon undergo. Especially with technology continuing to evolve, providers need to make sure they are leveraging all the tools available to them to deliver quality care.

For example, communication – between provider and patient as well as between all care team members – is especially critical. By communicating things as simple as appointment reminders and pre-procedure preparation instructions, healthcare organizations can reduce resourcing costs, delays, late cancellations and no shows, all ultimately helping to create higher patient satisfaction ratings. 

Why it’s time to shake up manual pre-surgical processes

It is not easy to overhaul processes that have been in place for some time. Clinicians and other end users can sometimes have an, “If it’s not broken, don’t fix it” mentality. If the current process is not actually harmful to patients and if surgery cancellation rates are not extraordinarily high, then what is the incentive to change? 

While the risks to patient safety and to the provider’s bottom line may not be obvious, manual care coordination produces negative ripple effects that lead to a chaotic and unstructured environment, wearing down the patient and clinician experience over time. 

For example, the assessment process itself is one of the first necessary steps for pre-surgery readiness. The nurse who assesses a patient right before a surgery is a critical connection, but she must also coordinate with the patient’s primary care provider. That PCP must coordinate with any specialist clinicians involved. A single communication mishap can cause inefficiencies and frustration on a broader scale, for multiple stakeholders. 

Similarly, manual appointment scheduling, including sitting on the phone attempting to connect with a provider, can be exasperating for sick patients who want to get in to see their physician as quickly and as easily as possible. 

From a business perspective, the need to change can be much clearer: it’s about volume, capacity and ensuring a positive patient experience. With greater efficiency, they can focus on increasing revenue while making sure the experience is still positive for patients. 

Enhancing patient and caregiver readiness ahead of surgery 

A well-coordinated communication plan ensures that the most appropriate protocol for a specific patient is delivered properly. But how can providers guarantee that a standardized and seamless pre-op experience becomes the norm?

Implementing the right technology – and properly training all end-users – can help orchestrate a truly patient-centric model of care. Patients can be accurately screened, tests are ordered in a timely fashion, high-risk patients are found early and pre-surgical instructions are communicated to patients with plenty of time before any procedure. 

Medical optimization is also a key component for patient readiness leading up to a surgery, but it can require a longer lead up time. For example, patients may need to stop smoking four to six weeks before surgery to mitigate the risk of anesthesia-associated complications. Similarly, they may need time to titrate medication to manage elevated blood pressure. In some cases, these optimization requirements might even delay the surgery to ensure that patients are optimally ready from a physiological standpoint. 

Patient engagement and communication are key aspects to patient readiness in the pre-surgical process, and evolving technology will likely be at the forefront of this two-way communication. Everything from appointment reminders to secure messaging and even patient portal usage will be automated by technology. 

Through all of that, providers must ensure that all stages of communications have been thorough, understandable and effective, and not just for the patient. They need to focus on all touch points, including caregivers. Family members, friends or hired caregivers need to be made aware of the procedure, what must be done leading up to it and what happens afterwards. It’s not just about the content itself being delivered – equally important is how content is delivered, to ensure that it is easily consumable.

Simply handing out a leaflet before the surgery for patients and their caregivers to read is not enough. There must be verbal instructions, along with information on how to reach out for any other questions that arise along the way: 

  • What time do we need to arrive before the surgery?
  • What preparations must be made? i.e., Do I need to stop taking any medications I’m currently on?
  • What is the plan for after surgery, such as medications that will be prescribed or how the patient will get home?
  • Will we be able to pick up the medications from our local pharmacy?

When patients are supported in a way that ensures all pre-surgical activities are properly completed, there will likely be fewer hiccups or cancellations come the day of the surgery. 

Personalization will also be key for patient readiness, ensuring that each care plan suits the individual based on his or her needs and specific requirements. Does every patient need a face-to-face appointment? Can a provider speak with a patient virtually instead? How are nurses communicating with patients, and then with other members of the care team? This not only creates efficiencies for the provider, but also creates a better patient experience. 

Proactively creating quality patient care 

Providers must focus on making sure that patients are not over or under evaluated when it comes to providing the best quality care possible. Essentially, there is a propensity for patients to undergo numerous tests before a surgery is even considered. Providers need to be able to effectively determine whether certain tests need to be done in the first place and properly identify the patients who actually need those tests. 

Failing to do so can impact healthcare costs – for both the provider and patient – and can also worsen the patient experience. No one wants to undergo an invasive or uncomfortable test, especially if it was not necessary in the first place. 

Having seamless pre-registration, including collecting basic patient information, such as patient demographic information, patient health history and checking the health payer coverage data, can help streamline the pre-surgical processes and improve the patient experience overall. 

In terms of the assessment, providers should consider if this can be completed digitally or over the phone, to prevent unwanted travel or time off work for the patient.

Tapping into technology to transform pre-surgery patient readiness 

A complete pre-surgery assessment process delivers greater efficiency, better experiences for caregivers and patients, and aids broader surgery optimization efforts by helping avoid last minute cancellations, no-shows and other mix-ups that can impact the surgery. The current system is siloed, manual and chaotic. But improvements in the pre-surgery readiness process and working toward consistent and thorough communication will improve both financial and clinical outcomes. 

The right technology can help hospitals and health systems efficiently scale a more streamlined pre-surgery readiness process, letting care teams manage and monitor an adaptive digital plan tailored to every patient. We must put the patient back at the center of care delivery. 

Dr. Gaj Srikanthan is Director of Clinical Pathways for Lumeon.

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