Abstract
OBJECTIVES: To assess the impact of a standardized pre-operative telephone checklist on the rate of late cancellations of ambulatory surgery (AMBUPROG trial). DESIGN: Multicenter, two-arm, parallel-group, open-label randomized controlled trial. SETTING: 11 university hospital ambulatory surgery units in Paris, France. PARTICIPANTS: Patients scheduled for ambulatory surgery and able to be reached by telephone. INTERVENTION: A 7-item checklist designed to prevent late cancellation, available in five languages and two versions (for children and adults), was administered between 7 and 3 days before the planned date of surgery, by an automated phone system or a research assistant. The control group received standard management alone. MAIN OUTCOME MEASURES: Rate of cancellation on the day of surgery or the day before. RESULTS: The study population comprised 3900 patients enrolled between November 2012 and September 2013: 1950 patients were randomized to the checklist arm and 1950 patients to the control arm. The checklist was administered to 68.8% of patients in the intervention arm, 1002 by the automated phone system and 340 by a research assistant. The rate of late cancellation did not differ significantly between the checklist and control arms (109 (5.6%) vs. 113 (5.8%), adjusted odds ratio [95% confidence interval] = 0.91 [0.65-1.29], (p = 0.57)). Checklist administration revealed that 355 patients (28.0%) had not undergone tests ordered by the surgeon or anesthetist, and that 254 patients (20.0%) still had questions concerning the fasting state. CONCLUSIONS: A standardized pre-operative telephone checklist did not avoid late cancellations of ambulatory surgery but enabled us to identify several frequent causes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01732159.