Aims North Bristol Trust is an 800 bed regional centre for Major Trauma Neurosurgery, Plastics, Vascular and Renal Surgery. It has 28 theatres with a though-put of ~120 patients per day. The aim of the project is to improve through-put through theatres by reducing non-attendance on day of surgery. This in turn leading to reduced wasted theatre time (~-£1500/hr) and improved trust revenue and efficiency, decreased surgery waiting lists, superior patient experience and satisfaction, and to improve staff morale.

Methods The initial approach was to phone patients~5 days in advance to remind them of their surgery and to check their intention to attend. However, non-attenders were still an issue so 59 of these patients were phoned to gather information on why they had not attended.

Results It was identified that approximately 54% of the Non-attenders were potentially avoidable: 33% no-longer wanted the procedure, 20% confused about the date, 20% inconvenient date, 7% did not want to wait, 20% were the wrong patient listed for the procedure.

Conclusions There appeared to be a failure in communication between patients and the hospital/staff on multiple levels. Firstly, patients being listed for procedures despite not wanting them. Secondly, it appeared that patients needed multiple reminders of their surgery date or reminders to cancel their surgery.

Strategy for Change The results were presented to the theatre efficiency group including the theatre manager -who have allocated funding to use an outsourced patient communication service. The service reminds and checks attendance more efficiently and effectively using text messages and phone calls. Team briefing has been used to highlight the results and promote better communication with patients. Posters in clinics have been used to promote a local CQUIN target to “ask three questions” which is aimed at empowering patients, and enabling them to opt out of surgery between referral and listing.