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A clinician explains an X-ray to a seated man.

Help Patients Navigate Preoperative Care.

Patients need to understand a sequence of instructions before an operation, while managing practical arrangements and questions about what comes next.

PATHS helps healthcare organizations turn clinical expertise into actionable patient journeys, giving patients and caregivers clear guidance while providing care teams with visibility into engagement, understanding, and progress.

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Preparing for Surgery Starts Before Arrival.

Patients need to understand a sequence of instructions before an operation, while managing practical arrangements and questions about what comes next. The surgical team sets those instructions for each person.

  • 1.23%4

    Day-of-surgery cancellations among elective cases at one U.S. hospital, January to May 2013

  • ~½ day2

    Shorter hospital stay after psychological preparation in a 2016 review, with low-certainty evidence

  1. The Problem

    Preparation combines individual medical instructions with practical arrangements. At one U.S. hospital from January to May 2013, 183 of 14,893 elective cases were cancelled on the day of surgery. New medical conditions were the most common reason; cancellation is not always a failure to follow instructions.1,4

  2. The Cost to Care Teams

    In that hospital's preoperative service, staff reviewed history and medicines, obtained records, arranged tests and consultations, and explained preparation. Some patients received nurse telephone screening; others needed a comprehensive clinical assessment. This coordination takes professional time beyond sending instructions.4

  3. When Preparation Is Unclear

    A cancellation disrupts a planned operation and the operating-room schedule. The study recorded both medical and non-medical reasons, so clear education cannot prevent every delay. Questions about illness, medicines or preparation still need review by the surgical team.1,4

  4. What Better Preparation Can Do

    A Cochrane review found possible reductions in pain, distress and length of stay after psychological preparation, with low-quality evidence. A separate hip and knee replacement review found no clear added benefit from education over usual care. Staffed assessment and preparation need clinical judgment; these studies do not establish PATHS outcomes.2,3

Sources

  1. 1.MedlinePlus. The night before your surgery. Reviewed June 27, 2026. Individual instructions remain the surgical team's responsibility.
  2. 2.Powell R, et al. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane, 2016.

Healthcare teams have a critical responsibility to educate and prepare patients for that journey. But once patients leave the clinical setting, how do we know they're ready?

Do they understand their care plan? Can they apply what they've learned? Are they following through? Where do they need additional support?

Preparing patients for the journey is essential. Knowing how they're managing it creates the opportunity to improve care.

Preoperative Care: From Clinical Expertise to Actionable Guidance.

  • Understand

    Education and knowledge

    Explain what the surgical team wants the patient to know about the planned procedure.

  • Take Action

    Tasks, decisions, follow-through

    Help patients work through preparation guidance and questions selected by their care team.

  • Manage Care

    Medications, appointments, self-care

    Keep the team's instructions and appointment preparation available to patients and caregivers.

  • Demonstrate

    Assessments and engagement evidence

    Use assessments to check understanding before the procedure and identify questions for follow-up.

Meet Nadia.She Gets Ready for Total Knee Replacement Surgery.

Follow Nadia, who has a total knee replacement planned, through an illustrative seven-Step Path. A hospital could use this structure to organize the instructions its surgical team selects, gather preassessment answers ahead of time and help patients arrive prepared.

Preparing for Total Knee Replacement Surgery Path

Illustrative person (AI-generated). Illustrative educational Path. Completion does not establish a clinical outcome.

Read the Path Steps
  1. Video: Understand her knee replacement

    Her surgical team explains what happens during a total knee replacement, the anesthesia they may discuss with her, and what to expect from her hospital stay.

  2. Virtual Event: Meet her surgical team

    A live online session where members of her surgical and anesthesia team introduce themselves and answer questions before the day of surgery.

  3. Form: Answer preassessment questions

    Nadia shares her health conditions, past operations, medicines, allergies and any past problems with anesthesia, and adds her own questions, for the team to review before her visit.

  4. Document: Read her medicine instructions

    Her surgical team’s written instructions on which of her medicines and supplements to take or pause before surgery, kept where she can revisit them.

  5. Document: Plan her ride and help

    A checklist for a responsible adult to drive her home, and for help with meals, shopping, bathing and laundry in the first weeks after surgery.

  6. Quiz: Check night-before steps

    Practice the steps her team gave her: when to stop eating and drinking, which medicines to take that morning, how to wash her skin, and to call the surgeon’s office if she feels unwell.

  7. Link: Get arrival-day details

    Where to go, when to arrive, what to bring, such as her medicine list, insurance card and any walker her team asked for, and the number to call if her plans change.

Download the full story (PDF)

Every Workflow Should Save the Health System Time and Money.

Assign a value to the Preparing for Total Knee Replacement Surgery Path and see the results.

Path Value Estimation

minutes
per year

How many times your team already does this workflow each year.

per hour

65.5staff hours saved per year

$2,291estimated value per year

Change the assumptions above to see your estimate of time and money saved.

  1. CREATE

    The care team builds a Preparing for Total Knee Replacement Surgery Path once.

    Preoperative nurses turn the preparation teaching they repeat with every joint replacement patient into a structured Path and assign it a value of 21 minutes of staff education time saved per patient.

  2. ENGAGE

    Patients like Nadia learn and act.

    Each year, 187 patients like Nadia prepare for knee replacement surgery with the Preparing for Total Knee Replacement Surgery Path, saving 21 minutes of education time each.

  3. KNOW

    Data shows the impact.

    That adds up to 3,927 minutes (65.5 hours) of staff time, worth an estimated $2,291 a year at $35.00 an hour.

  4. IMPROVE

    Insights improve the next Path.

    Engagement, knowledge checks and questions show where the preparation guidance was clear or confusing, so the care team can refine it for the next patient.

Every Preoperative Care Journey Creates an Opportunity to Improve the Next.

Estimates are illustrative and use the assumptions above. They are not measured results.

Nadia's Experience Becomes Health System Intelligence.

Nadia's care doesn't stop at one Path. Before her knee replacement, the hospital provides a Path for each part of getting ready: preparing for surgery, meeting her surgical team, her preassessment, her medicine instructions, and arrival day. Each Path Nadia completes also shows her care team what she engaged with, what she understood and what she still had questions about.

  • My Medicine Instructions Path

    Nadia can revisit her individual medicine instructions whenever she needs them. The questions patients ask show which instructions need work.

  • My Preparation Checklist Path

    Nadia has her team's instructions organized by the dates that matter. The steps patients miss show the team where the checklist can be clearer.

  • Arrival Day Path

    Nadia knows where to go and what to bring. Knowing where patients get stuck helps the team prevent surprises on the day of surgery.

The more the health system knows about each patient's experience and journey, the better it can make its workflows. What Nadia and every other patient engage with, understand and ask about becomes health system intelligence: the team learns from every patient and refines each Path, so the next patient's experience is better. Clearer Paths mean fewer repeat calls and less time re-teaching the same education, and that saves time and money across the health system.

Explore More Areas of Care.

1–6 of 25

Start With One Journey. Learn From Every Experience.

Improving preoperative care doesn't require changing every workflow at once.

Start with a patient journey that matters to your organization. Build a structured approach, understand how patients and caregivers engage, and use what you learn to improve the experience.

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