The Outpatient Procedure Unit, Unit Practice Council, identified a persistent challenge with gastrointestinal (GI) procedure cancellations occurring within 24 hours of the scheduled start time. A structured cancellation log and staff-initiated patient follow-up revealed the most frequent causes: patients deemed medically unfit, incomplete preparation, transportation difficulties, failure to notify (“no-show”), and miscommunication. Notably, a large proportion of cancellations were linked to patient misunderstanding of instructions. Analysis showed that patient-facing materials, including instruction sheets and reminder emails, were written at a 12th-grade reading level, while the national average literacy level is closer to the 5th grade. This discrepancy represented a modifiable barrier to patient comprehension and compliance.

In response, the team launched a quality improvement project to enhance communication and reduce preventable cancellations. All patient-facing materials were rewritten to a 5th-grade reading level to improve accessibility. Additionally, registered nurses implemented Modified Interactive Phone Calls, a technique in which patients answer structured questions to confirm understanding of preparation steps and key requirements. Data collection included monthly categorization of cancellations, direct patient calls to determine root causes, and systematic logging of outcomes.

The results were significant: patient cancellations decreased by 24%, with the department achieving an average cancellation rate of less than 5% within a four-week period. This improvement allowed the unit to see more patients per day, thereby reducing wait times for Kaiser Permanente members requiring GI procedures.

This initiative highlights the critical role of health literacy and interactive communication in improving patient compliance, optimizing procedural throughput, and enhancing overall patient experience. By addressing modifiable barriers, the Outpatient Procedure Unit successfully improved efficiency, reduced delays, and strengthened trust between patients and providers.