Cancelamento de cirurgias programadas em um hospital-escola: um estudo exploratório

Abstract

In spite of the extensive available literature on surgery patients' preparation and on the performance of surgeries, the focus given to the cancellation of the surgical act has been quite restricted. This study aims at identifying the number of scheduled and cancelled surgeries as well as the services that are mostly affected by such cancellations and was carried out in the surgery service of a big public university hospital located in the metropolitan area of Fortaleza, Ceará. The data were collected through surgery registration books, daily maps of surgery schedules and from the files of patients scheduled for surgery from September to December, 1996. The gathered data were analyzed quantitatively and introduced in charts. The results demonstrate that from the 1,145 surgeries programmed in the selected period, 379 (33%) had been cancelled. The mostly prejudiced services were General Surgery, Ophthalmology, Head and Neck Surgery, Trauma and Orthopedics, Otorhinolaryngology, Nephrology and Renal Transplant, and Proctology. Further investigation in this area in order to know the determinant causes of surgery cancellation as well as the participation of nursing in the study of this problem are necessary.

Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction

“…The study pointed out that those expenses could be avoidable, as long as the problems regarding flaws in administrative planning and mismanagement of the SC were fixed (1) . Several factors contribute to surgical cancellations: patient absence (1,10) ; unfavorable clinical conditions, mainly regarding decompensated chronic diseases, such as systemic arterial hypertension (SAH) and diabetes, in addition to lack of preoperative clinical exams (1,(10)(11) ; overrun of surgery time (10)(11)(12) ; non-availability of hospital bed (10) ; lack of articulation between surgical scheduling and the multipurpose team and a lack of computerization, which may cause errors leading to unnecessary cancellations (13)(14) ; type of hospital (university hospitals) (15) and of surgery (general surgery) (16) . Among the strategies proposed by the literature to reduce surgery cancellations are: pre-anesthetic or preoperative consultations (1,17) ; telephone confirmation of patient attendance two days before the procedure (10) ; restructuring of the work process, involving healthcare staff, information technology and mid-level professionals (18) .…”

Monitoring The Suspension Of Surgical Procedures

“…The suspension of an operation is an important occurrence, but has not always received the necessary attention from the health team and the manager. Apparently, the cancelation of scheduled surgeries causes no concern to the multidisciplinary team in most health services; it is seen as routine, inherent to the organizational and functional structure of the institution [3].…”

“…nally to the repercussions that involve the health institution with regards to its cost growth when you lose the opportunity to include other patient in the operating room, with underutilization of available resources, besides it increases the length of stay in the hospital environment [3].…”

Evaluando el indicador de desempeño suspensión quirúrgica, como factor de calidad en la asistencia al paciente quirúrgico

“…Las repercusiones catastróficas al paciente en las más diversas esferas, llegan hasta el rechazo psicológico de este procedimiento terapéutico por el mismo, pues la realización del acto quirúrgico es un acontecimiento importante en la vida de una persona, ya que mediante este procedimiento, esa persona espera vivir de forma más saludable, con mejor calidad de vida 4 .…”