Pre-procedure patient questionnaires reduce IR scheduling hiccups
A new paper details a quality improvement project aimed at addressing hiccups related to interventional radiology procedures requiring anesthesia.
As interventional providers have expanded their reach, utilization of IR procedures has seen significant growth in recent years. This growth is accompanied by the need to accommodate a larger number of patients with unique needs that warrant additional consideration to ensure safety.
Recently, a group of experts at Memorial Sloan Kettering Cancer Center integrated electronic questionnaires into their IR workflows to confirm that their patients’ medical needs were being thoroughly vetted. The questionnaires are part of a bigger effort to improve communication of relevant medical information to the appropriate parties. They're also aimed at ensuring patients with certain preexisting conditions or contraindications have their procedure done in a safe environment, as the use of anesthesia warrants additional safeguards.
A group of anesthesiologists and a nurse practitioner worked together to develop the questionnaire. They are sent through patient portals around a week prior to their scheduled procedure and address a myriad of medical concerns related to medication use, cardiovascular-specific medical history, issues with breathing, prior treatments to the head and neck area, and more.
The team investigated whether the questionnaires might reduce scheduling conflicts, including delays and cancellations, owed to patients being scheduled inappropriately as outpatients when their medical needs require resources only available in inpatient settings. To do this, they distributed surveys to patients undergoing IR procedures at their organization for one year.
Patients’ responses indicated the questionnaires were both well-received and informative. From a provider standpoint, the questionnaires proved to be beneficial in alerting staff to issues that warranted a second look at patients’ cases prior to the day of their procedure.
In the year following their introduction, the questionnaires resulted in 10% of scheduled IR cases being sent for additional review, leading to a small number of procedures being relocated to inpatient instead of outpatient settings due to medical concerns. These concerns were mostly centered around shortness of breath (8%), difficult airways (3%) and syncope.
“The successful implementation of the brief electronic questionnaire increased pre-procedure awareness of medical concerns in our patient population, included patients in team communication and guided appropriate scheduling time and location,” corresponding author Joanna Serafin, PhD, and colleagues noted. “It has since been expanded to include all procedures requiring anesthesia services that have historically not included presurgical testing, including gastroenterology, interventional pulmonology, radiation oncology, nuclear medicine, and radiology.”
Since the prescreening tool was initially implemented, the team has added additional questions about opioids and glucagon-like peptide-1 receptor agonists use. They have plans to conduct an additional analysis of how the questionnaires have impacted scheduling changes and cost savings in the near future.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.