Patient Prep Begins with Education

By |2019-01-16T08:22:45-05:00January 14th, 2019|

In today’s high-cost medical environment, we talk a lot about how it’s crucial that patients and care providers work together in a strong partnership. When it works, this is the ideal—but in an alarming number of cases, the patient fails to uphold his or her end of the bargain, resulting in missed appointments, poor preparation, delayed or cancelled procedures, and disrupted clinical workflow.

Consider just a few recent findings:

  • Up to 80% of appointments at chronic pain clinics in cities are affected by “poor appointment adherence,” resulting in wasted resources and increased wait times.[1]
  • One study found that, in a busy orthopedic unit, 80% of cancelled day-of-surgery-admissions were due to lack of patient prep for anesthesia.[2]
  • Another study found a no-show rate of almost 30% for primary care appointments, which can lead to increased use of emergency medicine and poor population management of chronic diseases.[3]
  • In a study of a 599-bed hospital, patient no-shows were responsible for 63% of all cancelled procedures.[4]

Researchers have looked at a number of ways to improve this, including phone calls from nursing staff and text reminders, but it may be the best option is to truly empower patients with education. A patient who understands his or her procedure, and has a clear understanding of what they need to do before they show up, is more likely to have a positive outcome.

And this is where quality patient education comes in. Today’s technology makes it easier than ever for hospitals and providers to reach patients where they are and, better yet, track and adjust their messages so patients can get the most from it. For example, a day surgery unit might prepare a bundle of educational videos and PDFs that can be automatically emailed just before patients come in for surgery, with instructions on how they can prepare. Back in the office, the nursing staff can see if the patients actually engaged with the material, and if not, follow up with a simple phone call. In fact, this approach has been shown to significantly reduce missed appointments in a primary care setting.[5] Or patients getting ready for orthopedic surgeries or bariatric surgeries can be enrolled in education care plans that send regular pieces of education through text or email with valuable tips on how to prepare for their anesthesia, thus saving time and money for both patients and providers.

The idea behind this is simple: harness the power of modern communication and education tools to give the patients the tools they need to fully and effectively participate in their own care. It’s always going to be true that some patients are more motivated than others, but if developing better ways to reach patients with targeted, tailored education before their procedures can improve outcomes even a few percentage points, it will make a real difference in people’s lives and in the overall cost of delivering medical care.


[1] Andreae MH, Nair S, Gabry JS, Goodrich B, Hall C, Shaparin N. A pragmatic trial to improve adherence with scheduled appointments in an inner-city pain clinic by human phone calls in the patient’s preferred language. J Clin Anesth. 2017;42:77-83.

[2] Dalton DM, Kelly EG, Murphy TP, McCoy GF, Glynn AA. Day of Surgery Admission in Total Joint Arthroplasty: Why Are Surgeries Cancelled? An Analysis of 3195 Planned Procedures and 114 Cancellations. Adv Orthop. 2016;2016:1424193.

[3] Shah SJ, Cronin P, Hong CS, Hwang AS, Ashburner JM, Bearnot BI, Richardson CA,Fosburgh BW, Kimball AB. Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial. J Gen Intern Med. 2016 Dec;31(12):1460-1466. Epub 2016 Aug 8.

[4] Abeeleh MA, Tareef TM, Hani AB, et al. Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement. Ann Surg Treat Res. 2017;93(2):65-69.

[5] Abeeleh MA, Tareef TM, Hani AB, et al. Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement. Ann Surg Treat Res. 2017;93(2):65-69.