Causes of Cancellations on the Day of Surgery at Two Major University Hospitals

Seim, Andreas R.; Fagerhaug, Tom; Ryen, Sveinung M.; Curran, P.A.; Sæther, Oddbjørn; Myhre, Hans O.; Sandberg, Warren S.

doi:10.1177/1553350609335035

Cited by 54 publications

(41 citation statements)

References 7 publications

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“…Studies at teaching hospitals in other countries, such as the United States and Norway, have reported that unfavorable clinical condi ons for surgery and lack of beds are major contribu ng factors, rather than absenteeism (15) . In a study evalua ng the cancella on of pediatric surgeries, the informa on provided to the mothers and/or rela ves was incomplete and superfi cial, which led to doubts and gaps in communica on and caused feelings of anxiety, fear, insecurity and anguish.…”

Section: Discussionmentioning

confidence: 99%

Confirmação de presença de usuário à cirurgia eletiva por telefone como estratégia para reduzir absenteísmo

Avila

Bocchi

2013

Rev. esc. enferm. USP

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RESUMOO presente trabalho trata-se de pesquisa quase experimental para avaliar o impacto na redução do absenteísmo de usuários agendados para cirurgia eletiva, quando submetidos à confirmação de presença por telefone. O estudo foi conduzido no Centro Cirúrgico do Hospital das Clínicas da Faculdade de Medicina de Botucatu, durante trinta dias, perfazendo 89 usuários. Os resultados indicaram a efetividade da intervenção, que reduziu o absenteísmo em 30%. Recomenda--se sua implementação na antevéspera da cirurgia, possibilitando novas tentativas para encontrar o usuário no domicílio e convocação de outro. A criação de um núcleo de atendimento poderia constituir um canal de comunicação entre instituição e usuário, permitindo a confirmação da presença da pessoa e a oportunidade de sanar dúvidas sobre o tratamento e comunicar eventuais impedimentos à cirurgia. O núcleo demandaria um profissional com habilidade e conhecimento do serviço, uma vez que os usuários requerem orientações sobre o tratamento durante o contato telefônico. DESCRITORES ABSTRACTThis study evaluated the reduc on in absenteeism by pa ents who were scheduled for elec ve surgery following confi rma on of the appointment by telephone. The study was conducted in the Surgery Room at the Botucatu School of Medicine for a total of 30 days and involved 89 pa ents. The interven on was eff ec ve in reducing absenteeism by 30.0%. Calling the pa ent 48 hours before surgery is recommended to allow suffi cient me to contact the individual at home and to schedule a diff erent procedure if necessary. Establishing a service center could be a communica on channel between the ins tu on and paents to confi rm that they are planning to be present. This service can also provide an opportunity to discuss concerns or quesons about the treatment and inform paents about impediments to the surgery. This type of center would require professional staff with medical skills and knowledge because the pa ents require orientaon regarding their treatment as part of the telephone contact. DESCRIPTORSGeneral surgery Absenteeism Telephone Evalua on Opera ng room nursing RESUMENInves gación cuasi experimental evaluando el impacto en la reducción del ausensmo de pacientes agendados para cirugía elec va, confi rmando su presentación por vía telefónica. Estudio realizado en el Centro Quirúrgico del Hospital de Clínicas de la Facultad de Medicina de Botucatu, durante 30 días, involucrando a 89 pacientes. Los resultados indican la efec vidad de la acción, que redujo el ausen smo en 30%. Se recomienda implementarla en la antevíspera de la cirugía, con empo para nuevos intentos de encontrar al paciente en domicilio o de convocar a otro. La creación de un centro de atención podría cons tuirse en un canal de comunicación ins tución-paciente, permi endo la confi rmación de la presencia, la oportunidad de subsanar dudas acerca del tratamiento y comunicar eventuales impedimentos para la cirugía. El centro demandaría de un profesional con habilidad y conocimiento del servicio, dado que los pacientes...

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Section: Discussionmentioning

confidence: 99%

Confirmação de presença de usuário à cirurgia eletiva por telefone como estratégia para reduzir absenteísmo

Avila

Bocchi

2013

Rev. esc. enferm. USP

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“…Our hypothesis was that this system would increase the number of case reviews and the number of SBP and PBLI learning opportunities. This represents part of our ongoing efforts to ensure the highest quality education possible through innovative technological methods [6] and a new application of information systems in our ongoing efforts to track and compare causes of day-of-surgery cancellations [19].…”

Section: Introductionmentioning

confidence: 99%

Automated Case Cancellation Review System Improves Systems-Based Practice

et al. 2015

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“…Cancellation reasons also vary across studies including medical condition changes, patient no show, and scheduling issues. Importantly, most of these studies are retrospective, which does not permit accurate assessment of time sensitive factors which might cause some inaccurate explanation of the cancellation; and the outcomes might have selection bias [2,5,8].…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Elective Case Cancellation for Inpatient and Outpatient in an Academic Center

Xue

Yan

Barnett

et al. 2013

J Anesthe Clinic Res

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Background: Unexpected surgical cancellation is common and can have significant adverse effects. Cancellation rates vary because of a lack of a standard definition, different patient populations and study methodology. We hypothesized that case cancellation has a different pattern in a dedicated ambulatory surgical center compared to a general operating room (OR) setting in a large academic center without an anesthesia preoperative evaluation center necessitating evaluation by the various surgeons.Methods: Elective cases in general OR and in the ambulatory surgical center were included in this study. Elective cases are defined as the non-emergent cases scheduled before 8:00 am on the day of surgery. A cancelled case was defined as a scheduled procedure which is not performed on the scheduled procedure day. Case cancellation was monitored in real time using an electronic patient flow system (Navicare). As soon as the case is cancelled, the reason for the cancellation was obtained from the surgeon, the anesthesiologist, the OR coordinated nurses and/or the floor nurse. In the day surgical center, the cancelled cases were followed to determine whether/when they were rescheduled.Results: 4261 elective cases were included in this investigation, including 2751 cases in the general OR and 1510 cases in the ambulatory surgical center. A total of 283 cases (6.6%) were cancelled which include 206 cases from the general OR and 77 from the ambulatory surgical center. The cancellation rate in the general OR was 7.5%, among which inpatients have the highest cancellation rate of 18.1%, followed by outpatients at 4.6%, and same day admission at the lowest cancellation rate of 2.0%.The top 3 reasons for cancellation in general OR werein adequate preoperative preparation 29.4 ± 4.5%, medical condition change 28.5 ± 10.2%; and scheduling issue 20.2 ± 7.1%. Most (59.2 ± 8.9%) of the cancellations was considered preventable, 12.3 ± 5.9% was considered potentially preventable, and 28.5 ± 10.2% were not preventable (such as patient condition changes). The cancellation rate in the ambulatory surgical center was 5.1%. The major reason for cancellation was patient no show 75.8 ± 5.2 %, 61% of those no show patients were rescheduled and the mean delay in surgery was 18 days (range from 1 day to 84 days). Conclusions:Case cancellation is not un-common in a large academic center without a preoperative evaluation clinic. The dynamics of case cancellation are different in an ambulatory surgical center as compared to the general OR. Inpatients have the highest cancellation rate associated with inadequate preoperative preparation and scheduling, this should be preventable via adopting proper systems of evaluation and preparation. Most of the case cancellations in the ambulatory surgical center are from patient no show, suggesting that administrative strategies to reduce this issue should be implemented. The patients admitted on the same day of surgery had the lowest cancellation rate requiring minimal intervention.

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Causes of Cancellations on the Day of Surgery at Two Major University Hospitals

Cited by 54 publications

References 7 publications

Confirmação de presença de usuário à cirurgia eletiva por telefone como estratégia para reduzir absenteísmo

Confirmação de presença de usuário à cirurgia eletiva por telefone como estratégia para reduzir absenteísmo

Automated Case Cancellation Review System Improves Systems-Based Practice

Dynamics of Elective Case Cancellation for Inpatient and Outpatient in an Academic Center

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