Archive November 2017 XVIII, No. 11

Ideas That Work: One Simple Change Will Reduce Your Add-Ons

fewer add-on cases ADVANCE NOTICE Asking your surgeons to schedule patients at least 3 days in advance could result in fewer add-on cases.

One Simple Change Will Reduce Your Add-Ons

Add-ons were a big problem at our facility — they accounted for 27% of our cases. Add-ons can be an expensive hassle, forcing you to shift personnel, pay overtime, manage stress and even cancel cases. They can also force people to hurry and make careless mistakes.

Turns out, the problem was in how we scheduled our cases: in a big rush, thanks to physicians with block time who often held their cases until a day or 2 before surgery and then added several patients to the schedule all at once. Naturally, that didn't always leave time for pre-admission testing or for dealing with patients who required anesthesia consultations. The result was an overbooked schedule with lots of add-ons.

We reduced our percentage of add-ons to 10% by asking our surgeons to schedule elective cases at least 3 days in advance. We also created a scheduling checklist so surgeons' schedulers and office managers knew what information we needed in order to put a patient on the schedule — and which patients we couldn't add to the schedule just yet.

Barbara J. Holder, RN, BSN, LHRM, CAPA
Andrews Institute Ambulatory Surgery Center
Gulf Breeze, Fla.

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