In 2012, 11 ambulatory surgical facilities (ASFs) in the northeast region of Pennsylvania worked in collaboration with the Pennsylvania Patient Safety Authority to address the nurse-driven preoperative screening and assessment process in an effort to reduce day-of-surgery (DOS) cancellations and transfers. The ASFs tracked the time when the nurse-driven preoperative screening and assessment process was completed (e.g., 24 hours prior to the DOS). A statistically significant difference was noted between no-show DOS cancellation rates in patients with and patients without a preoperative screening and assessment. Reasons for DOS cancellations and transfers and types of surgeries or procedures were also tracked. To continue the identification of DOS cancellations and transfers, the ASF Cancellation and Transfer Tracking tool was developed to identify trends regarding when a nurse-driven preoperative screening and assessment process has been completed, reasons for DOS cancellations or transfers, types of surgeries or procedures in patients who cancelled or were transferred, and patient characteristics associated with patient transfers. Identifying reasons for patient cancellations and transfers to an acute care hospital provides context about patient circumstances or situations that can assist healthcare staff in developing appropriate solutions to reduce their occurrence and improve patient care.
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