Boston Children’s Hospital

Case Study

High procedural/surgical reschedule rate due to poor NPO compliance

Mama Bear and GoldilocksBoston Children’s Hospital (BCH), one of the world’s leading children’s medical centers, performed more than 26,500 surgical procedures in 2013. Of course, prior to any surgery or procedure requiring anesthesia, children and their caregivers are given pre-op consults and written instructions about when to stop eating and drinking before their scheduled procedure (NPO instructions). These guidelines can be quite complicated due to varying factors for infants, toddlers, and older children. Such complexity was the principal contributor to BCH’s unacceptably high day-of-procedure reschedule rate.

Traditional teaching methods and printed educational materials proved to be ineffective at lowering the NPO non-compliance rate and were time-consuming for hospital staff . Ongoing high rates for day-of-appointment rescheduling continued to drive surgical suite down-time and significant loss of revenue, not to mention frustration among patients, clinicians, and support staff.

Script page

Engage patients and parents with custom animation to simplify message and delivery

BCH contacted Health Nuts Media (HNM) to develop a solution that would engage patients and their parents to improve the understanding of pre-op NPO guidelines, increase compliance, and lower same-day surgical reschedule rates. HNM’s team of writers, animators, actors, translators, editors, producers, and physicians worked with clinicians at BCH to develop a tool (in both English and Spanish) to convey the complex NPO guidelines in a simple, easy-to-follow, and fun format: “Don’t You Dare Eat That!”– a charming animated educational video featuring Goldilocks, Mama Bear and Baby Bear that delivers crucial education in an engaging and memorable way.

Dr. Hiep Nguyen quote

NPO listImprovement of patient-parent engagement and decline in surgery and procedure reschedules

The video has been warmly received by patients and clinicians alike. In particular, BCH stakeholders committed to diversity and cultural competency have embraced the Spanish version as an example of how to instill a welcoming environment, bolster respect for cultural differences, and improve community outreach. Study design is underway to measure the impact upon family understanding and compliance of pre-procedural NPO guidelines and its reduction in surgical reschedule rates and associated costs.