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Reducing Surgical DNAs at Sheffield

Wed 24th June, 2015
Reducing Surgical DNAs at Sheffield

Sheffield Teaching Hospitals NHS Foundation Trust began their LiA journey last September, and will soon be showcasing their achievements so far at their LiA 'Pass it On' event in July. 

Lisa Walton, Operations Director for Operating Services, Critical Care and Anaesthesia is working with a team who wanted to reduce cancelled operations. They are already seeing some fantastic results which Lisa shares here:

"Our team has focused on reducing the on-the-day cancellation rate due to patients not attending their surgery appointment (DNA) and ‘unfit’ patients attending when they are not well enough to undergo their procedure.

Our information showed that the highest rate of these two cancellation causes was seen across our day case patients within the Plastics and General Surgery directorates, so we chose to start by looking at how we could make improvements there.

We held LiA Conversations with staff who shared many ideas about how we might reduce these causes. The most popular suggestions were to introduce both reminder calls and texts.

For the reminder calls, we designed a new script that is concise and easy to follow. The script consists of questions surrounding the patients’ health (e.g do have they flu-like symptoms), whether they are still planning to come in for their operation and if they have someone to provide them with transport home. Liz Wright, a registered nurse, was seconded from Emergency Medicine to undertake an evening call trial initially in Plastic Surgery. The trial has now been running for the past six weeks with great results.

Since the calls have been in action, Plastic Surgery has avoided several cancellations on the day due to patients not realising they had an appointment, transport not being arranged or patients just not wanting to come in for their procedure. Gaining the knowledge that the patient will not be attending in advance then allows for the Waiting List Co-ordinators to bring another patient into that all important slot.

The DNA rate for the pilot area has dropped from 9 in May 2014 to only 4 in May 2015. Our most recent data received just this week shows us that for the first time we have surpassed the 4% target for cancelled ops at 3.85%! Although there are improvements that can still be made to this, the calls have been so successful that this will soon be rolled out to General Surgery patients too.

The calls are not only having a positive impact on DNA and cancellation rates, they are also improving the overall patient experience, as patients are able to query starving details, medication and admission times with the caller.

Our next phase which is close to being implemented is reminder texts for patients who are due a surgical procedure to complement the reminder phone calls. Our plan is to expand this to all inpatients within the Trust. We are also planning a communications campaign to highlight the importance of patients attending for their appointments using the website, GP surgeries and outpatient areas".

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