Use of pre-procedure electronic questionnaire to enhance scheduling and safety in interventional radiology procedures with anesthesia care

Abstract

The growth of interventional radiology (IR) procedures with anesthesia team care in increasingly medically complex populations points to the need for effective and efficient pre-procedure screening. We present an ongoing quality improvement project involving a brief online questionnaire disseminated to patients three to ten days before the day of their scheduled IR procedures. The questionnaire was developed by anesthesiologists and a nurse practitioner to increase pre-procedure awareness of relevant medical concerns, guide scheduling of procedures at outpatient versus inpatient locations, and improve patient pre-procedure management. The response rate after one year was 57% and indicated that at least 1 in 10 patient histories required review and discussion by the care team. The most common concerns were shortness of breath (8%), difficult airway (3%) and syncope (3%). Most procedures proceeded as scheduled, however, 18 procedures (0.4% of patients who responded), had to be rescheduled from an outpatient to the inpatient site due to medical concerns. The electronic pre-procedure screening has been feasible to implement at a busy clinical practice and has improved team communication, patient preparedness, and scheduling at appropriate locations. The team has since expanded the questionnaire to other non-operating room anesthesia procedures and added questions about opioids and glucagon-like peptide-1 receptor agonists use. Future work needs to evaluate whether the online pre-screening was associated with decreases in cancelation rates and cost savings.

Keywords: Interventional radiology; Organizational efficiency; Patient selection; Preoperative screening; Quality improvement; Scheduling.