The Implementation of an Evidence-Based Patient Decision Aid for Lumbar Epidural Procedures: A Quality Improvement Project
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Date
2025-05
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The Ohio State University
Abstract
Background: The standard benchmark for outpatient procedure cancellation is less than 5%. Most procedure cancellations are avoidable and can be prevented with thorough patient evaluations and proper preparation, highlighting the critical role of standardizing patient education to help increase compliance with pre-procedure instruction.
Purpose: This project aimed to improve patient understanding of the lumbar epidural steroid injection procedure and reduce the number of procedure cancellations by 25%.
Methods: A quality improvement project using the Plan-Do-Study-Act (PDSA) framework was conducted to implement an evidence-based patient decision aid for lumbar epidural steroid injections (LESI). Outcome measures included (a) the number of cancellations for LESI procedures, (b) the frequency of decision-aid usage and patient-reported helpfulness, and (c) provider feedback on the decision-aid intervention.
Results: Twelve health providers participated in this project. The evidence-based patient decision aid was utilized for approximately 50% of patients. Among the patients who reported receiving the evidence-based decision aid, 97.1% found it helpful. The physical medicine and rehabilitation (PM&R) team experienced a 24.8% reduction in lumbar epidural procedure cancellations.
Conclusion: The data from this project suggest that an evidenced-based lumbar epidural patient decision aid should continue to enhance verbal patient education when scheduling a lumbar epidural procedure.
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Keywords
patient education, elective procedures, lumbar epidural education