Preparing patients for surgery is a task healthcare organizations strive to optimize.
Electronic messaging (EM) provides an opportunity for streamlining components of this
arduous process. Our study aims to evaluate our early experience in utilizing EM to
provide preoperative information to pediatric urology patients.
To assess the effectiveness of EM in preparing patients for pediatric urologic surgery.
This study compared a 6-week pilot program of EM (Figure 1) with traditional nurse
phone calls (NPC) in preoperative instruction of pediatric urology patients. The same
preoperative instructional information was provided via either source. Data collected
included time and resources used by the healthcare system and patient/parent satisfaction.
The EM group included 98 patients, while the NPC group included 212 patients. Case
cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate
in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z = −1.137, p = 0.25).
There were 4 EM-related operating room delays with an average case delay of 31.5 min
(5–60 min). Twenty-four (24%) EM patients/families required secondary phone calls,
while 106 (50%) NPC required a follow up phone call (p < 0.01). 94% of EM participants
recommended EM for future perioperative instructions. Accounting for the average case
volume within our entire children's hospital, the average total daily cost for EM
is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This
represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based
upon average total case volume at our institution.
In our initial experience, EM effectively communicates the necessary preoperative
information to patients and/or families undergoing pediatric urology surgery. Our
results demonstrate low case cancellation and delay rates and high patient/family
satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM.
A great benefit of EM was the increased time it provided for nurses to perform other
patient care duties, which is important given our current nationwide nursing shortage.
Limitations of the study included a narrow scope assessing only pediatric urology
patients as well as a short study period. Further studies will further define and
refine the role of perioperative EM.
Changing to an EM system for preoperative instructions in the pediatric urology population
met with a high degree of patient satisfaction and decreased costs for healthcare
systems without increasing case delay or cancellation rates.