Eyeworld

6 Ophthalmology Business • March 2017 by Liz Hillman, Staff Writer Cutting down on From Ms. Damiano's perspective, fear is a leading cause for same-day surgical cancellations for conditions that are not an emergency. "The eyes are a sensitive organ and a vital part of anyone's daily life, so it's no surprise that patients are anxious beforehand, even when the procedure can significantly improve their vision, such as LASIK surgery," she said, adding that she and her team "go to great lengths to make each patient feel comfortable, and this includes frequent check-ins leading up to the procedure to an- swer any questions and address any concerns." David Norris, MD, Wichita Anesthesiology, Wichita, Kansas, said from his perspective as an anes- thesiologist, surgeries are cancelled most often because patients have not complied with nil per os (NPO) Ocular surgery cancellations at the ambulatory surgical center of Massachusetts Eye and Ear, Bos- ton, from 2001 through 2003 were analyzed with results published in 2006. 1 Of the 7,153 cases during that time period, 5.35% were cancelled within 24 hours of surgery. Of these, 41% were considered "preventable," 45% "unpreventable," and 14% did not have a reason. Cancellation rates were higher in winter months and among pediatric cases. These late cancellations at Massachusetts Eye and Ear were estimated to cost at least $100,000 per year. "Having a patient cancel at the last minute disrupts any doctor's schedule and represents a missed revenue opportunity," said Donna Damiano, Laser Center manager, Northeastern Eye Institute, Scranton, Pennsylvania. Reasons for same-day surgery cancellations and how to avoid them T he instruments are prepped, implants and machinery are ready, but then the patient doesn't show up, or he or she does arrive but is deemed medically unsuitable for surgery. Same-day surgery cancellations are an inconvenience for everyone involved. From the surgeon and center's perspective, it's a scheduling disruption and loss of productivity. From patients' perspective, should they arrive and be rescheduled for another day, it's another day of anxi- ety, possibly another day off work for them and the person accompanying them, and another day without a procedure they need to improve their quality of life. Keeping cancellations down • Instruct patients well ahead of time on NPO guidelines, medication dos and don'ts, and the time you want them to arrive for surgery. • Schedule patients requiring more medical management (diabetes, high blood pressure, and children) earlier in the day. • Try delaying surgery for later the same day, attempting to stabilize certain medical conditions to allow for operating.

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