Dissertation
Reducing Same Day Cancellations of Pharmacologic Stress Tests: A Quality Improvement Project
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Heart disease is the leading cause of death in the United States, claiming a life every 33 seconds (Center for Disease Control and Prevention, 2024). This statistic is a reminder of the urgent need for effective cardiac care. Pharmacologic stress testing is a crucial diagnostic tool that facilitates the early detection of heart disease, enabling timely intervention and treatment to prevent further heart damage and enhance outcomes (Lak et al., 2025). However, same day cancellations disrupt patient care, waste resources, and delay treatment of cardiovascular conditions. Purpose: To implement a phone call reminder system that provides procedure preparation instructions one business day before stress testing, aimed at reducing the rate of same day cancellations, minimizing revenue loss from cancellations, and increasing staff satisfaction. Methods: This quality improvement project took place in a Midwest hospital cardiac stress lab and involved 650 adult participants (374 in 2023 and 276 in 2024) and nine nuclear medicine technicians. The Iowa Implementation Framework for Sustainability guided the implementation process through stages of awareness, knowledge building, action promotion, and integration (Cullen et al., 2018). Staff engagement was fostered via surveys and training sessions to ensure proper execution. Findings: The intervention resulted in an 8.8% difference in cancellation rates, dropping from 13.1% in 2023 (pre-intervention) to 4.3% in 2024 (post-intervention). Revenue loss due to cancellations decreased by 75.5%, with lost revenue decreasing from $378,476 in 2023 (pre-intervention) to $92,688 in 2024 (post-intervention). Staff satisfaction survey scores increased by 6.8%, rising from 18.25 in 2023 (pre-intervention) to 19.5 in 2024 (post-intervention). Discussion: All three project goals were successfully met: reducing cancellation rates, minimizing revenue loss, and enhancing staff satisfaction. These outcomes improved patient access to care, supported staff workflow, and strengthened the institution's financial stability, underscoring the importance of integrating a patient reminder system in healthcare settings.
Details
- Title: Subtitle
- Reducing Same Day Cancellations of Pharmacologic Stress Tests: A Quality Improvement Project
- Creators
- Andrea Timmerman - University of Iowa
- Contributors
- Larry Newman (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Adult/Gerontology Nurse Practitioner (Acute Care)
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Andrea Timmerman
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841036002771
Metrics
2 Record Views