Problem: The ideal rates for same-day surgical cancellations for U.S. hospitals are less than five percent per year, though any cancellation negatively impacts the patient, staff, and hospital. A recent annual evaluation showed that the average number of cases canceled per month for orthopedic and neurosurgery services in a community hospital was three per week (2.6%). Interviews with the preadmission nursing staff attributed this to the preadmission health assessment calls made the day before surgery, revealing an opportunity for development. The cardiac clearance processes were also found to need improvement. Evidence supports preadmission health assessment calls to be completed at least two days before the surgery. Conducting screening calls to evaluate cardiac clearance up to 30 days before surgery can reduce cancellations. Purpose: This project aims to reduce same-day surgery cancellations in orthopedic and neurosurgery patients by changing the timing of preadmission health assessment calls to two days before surgery and creating a cardiac clearance screening call to improve care coordination. Methods: Nursing staff were cross-trained to help move preadmission health assessment calls at least two days from the surgical date. A new report and screening call were created to verify cardiac clearance up to 30 days before surgery. Orthopedic and neurosurgery service rates and reasons for cancellation were analyzed weekly during project implementation. Results: The timing of the preadmission health assessment calls increased to 13%, completed two days before surgery. Same-day surgery cancellations were reduced to two per week. No cancellations due to inadequate cardiac clearance occurred during the project. Conclusion and Implications for Practice: Three hundred and fourteen preadmission health assessment calls were performed two days before surgery and improved coordination of care. Cancellation rates were reduced to 2.3% during the 15 weeks of the project. Earlier coordination of care for patients needing cardiac clearance was effective, as there were zero cancellations.