Cancellation of Surgeries by the Patient, Doctor or Institution: An Approach to Legal Ethical Aspects

Abstract

INTRODUCTION: The cancellation of surgery represents a dilemma in establishing relatively adequate cancellation rates according to the factor, because each institution and surgical specialty have different dynamics. Objective: Describe the types of factors present for the cancellation of surgeries in a health institution. Colombia (2017-2018).
 
 METHODOLOGY: Descriptive, retrospective, cross-sectional study. We reviewed (3339) records of scheduled surgeries from January to December 2017. In 2018 they were reviewed (1733) between January and June. A total of (5072) records of a Third Level Health Institution of the Department of Cesar / Colombia were reviewed. The Neuronal Multilayer Perceptron Network model and the Gini coefficient were applied to determine the most important factor and therefore the inequality between them. 
 
 RESULTS: In 2017, there was a surgical cancellation rate of 4% of the total number of scheduled surgeries (3339). For the year 2018, the rate was 3% of the total of scheduled surgeries (1733). The most important factor was due to the patient's adverse conditions. The surgical specialties that had the highest number of cancellations were general surgery followed by orthopedics. 
 
 CONCLUSION: An evaluation of the factors for the cancellation of programmed surgeries with a high coefficient of inequality is described. In addition, the most important factor was related to the patient. Prospective studies by specialty are proposed for the design of solution and monitoring strategies to avoid surgical cancellations.

Legal Implications for Actions Considered Iatrogenic: Knowledge and Practices of the Surgical Team, Valledupar, Cesar/Colombia

“…With regard to the procedure to be followed once the iatrogeny or error has been committed, it is necessary to take into account that, although the responsibility of talking to patients and/or their families about these results generally lies on the treating physician, nurses are often also involved because they are "closer" to the patient. This conversation between doctors/nurses and patients and/or relatives when something "bad" has happened is what the Anglo-Saxon literature has called "disclosure" (Pérez, 2019;Anderson et al, 2019;Aguirre-Gas & Vázquez-Estupiñán, 2006). In the United States, this dialogue is not only one of the best institutional practices, but also a requirement of the Joint Commission to grant or maintain accreditation to hospitals and therefore it must be considered within the rights of patients (Franco, 2006).…”