Nurse Practitioner-Led Preoperative Care Teams Decrease Costs

The utilization of Nurse Practitioners (NPs) during preoperative care has multiple benefits, including cost savings associated with the reduction of surgical cancellations, decreased laboratory utilization, and shorter hospital stays. Preoperative care is individualized to the patient’s needs and covers both the physical and psychological preparation of the patient for surgery. Such care can include the discussion of the benefits and risks of the procedure, what the patient’s expectations of the procedure are, and the length of recovery, among other areas of concern. It has been found that patients who have a better understanding of their procedure, and who are better prepared for what is to come, experience improved post-op recovery. Preoperative care can cover the span of weeks to a day before the procedure. Surgeons are often unable to devote a large amount of time to preoperative care. By having interdisciplinary teams that focus on preoperative care, patients see a reduction in anxiety associated with surgery resulting in better outcomes. “Nurse practitioners are well poised to lead interdisciplinary teams to improve preoperative care coordination,” stated Aaron Sebach, DNP, MBA, FNP-BC. In NP led preoperative care teams, NPs will explain the procedure and educate the patient so that the patient understands all of the pertinent information prior to surgery day, thus providing the patients with “a sense of continuity in a traumatic time.” By devoting more time to preoperative care, NPs on average are able to spend more time with the patient and his or her family, answering questions, providing stability, and gaining a better understanding of the individual patient’s situation and care needs. In a study comparing revenue losses between an NP led preoperative evaluation and a standard preoperative care clearance, patients who participated in an NP led preoperative evaluation had only one surgery cancellation, resulting in $4,276 in lost revenue. When paralleled against 36 surgery cancellations running $184,480 in lost revenue in the standard care group, the economic benefits of NP participation in interdisciplinary preoperative care teams are astronomical. Another study conducted by the National Center for Biotechnology Information on NP led preoperative care in Pediatric Surgery found that within a year, the program had “maintained patient safety, timeliness, and a high level of parent satisfaction as well as increased staff satisfaction, while shifting two anesthesiologists to the OR.” Hospitals see the greatest financial benefit in opening a preanasthesia clinic, with an inpatient ward savings of $1.14 million a year. Taking note of these benefits, a number of hospitals have opened varying preoperative care clinics, including Cincinnati Children’s Hospital, Children’s Medical Center of Dallas, the University of California Los Angeles, and the University of Iowa Hospitals and Clinics, amongst others. Ensuring that preoperative care is coordinated and standardized will increase patient satisfaction and thereby decrease surgical delays and cancellations. Integrating advanced practitioners into preoperative care strategies can thus significantly decreasing healthcare spending.