Presurgical Clinical Clearance

The Challenge

A client faced persistent challenges in their presurgical process, leading to a troubling number of last-minute cancellations and rescheduled surgeries. Each cancellation cost the organization an estimated $7,500 per event in wasted OR time, staffing inefficiencies, equipment allocation issues, and backfill challenges.

Underlying problems included:

• Difficulty tracking clinical deficiencies across multiple departments
• Slow or inconsistent communication with primary care, anesthesiology, surgeons, and specialists
• Missing or outdated history and physicals, labs, and diagnostic results
• No real-time visibility into which patients were at risk of cancellation
• Manual follow-ups and data entry that introduced delays and errors

The organization needed a unified, automated workflow that would ensure all required clearances and documentation were completed before the date of surgery.

The Solution

Our team implemented a comprehensive Clinical Clearance Workflow using automated deficiency management to ensure every step of the preoperative process was completed on time.

Key Workflow Components

1. Order Review: The surgical order automatically triggered the workflow. Users could review, validate, and analyze the order directly from within the system. Incomplete or incorrect orders were returned immediately to the originating provider to prevent downstream delays.
2. Results Capture & Classification: Incoming results, H&Ps, consult notes, and supporting documents were automatically received and classified. When documentation arrived, associated deficiencies were automatically resolved—no manual updates required.
3. Abnormals Management: For abnormal diagnostic findings, the workflow automatically generated clearance requests to the appropriate provider. Specialists could electronically clear the patient or add notes, reducing back-and-forth communication delays.
4. Interview Checklists: Integrated preoperative interview checklists captured patient-reported information, risk factors, and readiness details. Responses became part of the surgical packet and the patient’s chart.
5. Chart Creation & EMR Integration: All captured documents and workflow outputs flowed directly into the EMR. A complete preoperative chart was assembled automatically—before the patient arrived for surgery.
6. Focus on Near-Term Surgical Dates: Priority dashboards ensured staff focused first on surgeries at highest risk of cancellation, enabling proactive outreach and accelerated clearance.

Impact / Results

Operational & Clinical Benefits

• Significant reduction in surgical cancellations, eliminating avoidable $7,500 events.
• Streamlined communication between multiple providers and specialists.
• Real-time visibility into surgical readiness across all upcoming cases.
• Automated deficiency resolution minimized manual tracking and follow-up.

Financial Impact

• Avoided hundreds of thousands in losses from preventable cancellations.
• More efficient OR utilization and staffing allocation.
• Reduced administrative labor required to chase documentation.

Patient & Provider Experience

• Patients experienced fewer reschedules and delays.
• Surgeons and anesthesiologists received organized, complete charts before surgery.
• Improved trust and coordination across clinical teams.

Organizational Outcome

The automated Clinical Clearance Workflow transformed a fragmented, error-prone preoperative process into a structured, efficient, and proactive system—ensuring surgeries proceeded on schedule and restoring confidence across departments.