High Elective Surgery Cancellation Rate in Malawi Primarily Due to Infrastructural Limitations

Prin, Meghan; Eaton, Jessica; Mtalimanja, Onias; Charles, Anthony

doi:10.1007/s00268-017-4356-1

Cited by 33 publications

(43 citation statements)

References 25 publications

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“…Cancellation of elective operation on the intended day of surgery (DOS) is considered when a patient’s name has appeared on the list for surgical operations but the operation was not done on the intended scheduled date [ 1 ]. DOS cancellations are a world-wide problem, ranging from 0.37–28% in developed [ 2 – 9 ] and from 11 to 44% in developing countries [ 10 – 14 ]. It can be avoidable and non-avoidable [ 15 ] and avoidable cancellations were the commonest [ 4 , 16 , 17 ].…”

Section: Back Groundmentioning

confidence: 99%

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

et al. 2018

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BackgroundElective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological trauma to patients and their families. Despite little is known in Ethiopia. Therefore, this study aimed to assess incidence and reasons of cancellations of elective operation on the intended day of surgery at tertiary referral academic medical center in Ethiopia.MethodsA prospective hospital-based cross-sectional study design was conducted in a tertiary referral academic medical center in Ethiopia among 146 participants. A self-administered questionnaire with an observatory checklist was used for collecting data from the anesthetist, nurse, and surgeons.ResultIn this study, 462 patients were scheduled for elective surgical operations. Among those, nearly almost one-third 146 (31.6%) of the operations were cancelled and 316 (68.4%) patients were operated on their planned date. The most common reason for cancellation were surgeon related (35.8%), patient related (28.7%), management related (21.2%) and anesthesia related factors (14. 4%). The cancellation was mainly due to improper scheduling (20.5%%), unavailability of surgeons (8.9%), unavailability of oxygen and blood (8%) and equipment (5.5%). Orthopedic (28.8%) and general surgery (17.1%) were the commonest cancelled cases.ConclusionThe cancellation rate in our academic medical center remains high. Improper scheduling, unavailability of surgeons, medical illness, and unavailability of operating room equipment were the commonest reason for the cancellation of elective operation. Most cancellations were preventable. For this, proper preoperative assessment, proper scheduling, fulfilling necessary operating room equipment’s and cross-matched blood by the hospital and other stakeholders, early clear communication with operating room team like surgeons was recommended.

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Section: Back Groundmentioning

confidence: 99%

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

et al. 2018

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“…Besides, management strategies or surgical settings might be similar in developing countries, but lower than a study conducted in Nigeria [23], Uganda [35] and Malawi [21]. This discrepancy might be due to ndings of cancellation varying widely by study design; hospital type, country, and capacity; patient type (inpatients vs. outpatients).…”

Section: Discussionmentioning

confidence: 91%

“…Based on the estimation of the reason for elective surgical case cancellation, the most common identi ed reason was administration-related reasons. The same report from the Kingdom of Saudi Arabia [17], Jordan [18], Uganda [35], and Malawi [21] showed that administration-related reasons found the most common reasons of elective surgical case cancellation. This might be due to the reality is that surgical case cancellation can result in the nancially under-utilization of theatres [2].…”

Section: Discussionmentioning

confidence: 98%

“…Varity of reasons listed for the cancelled operations. Of these administrative-related accounted for 30.4% [18] to 84.8% [21], patients' related accounted for 25.9% [17] to 68.28% [22], medical-related reasons and surgeon-related reasons accounted for 38.2% [18], 28% [23] respectively. In Ethiopia, different primary studies had conducted to determine the prevalence of elective surgical case cancellation and reasons.…”

Section: Introductionmentioning

confidence: 99%

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Elective Surgical Case Cancellation and Reasons in Ethiopia: A Systematic Review and Meta-Analysis

Yohanes¹,

Sinshaw²,

Ayisa³

2020

Preprint

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Background: Cancellation of elective surgical operation recognized as a major cause of emotional trauma to patients as well as their families. In Ethiopia, prevalence and reasons for elective surgical case cancellation are variable from time to time in different settings. This systematic review and meta-analysis aimed to find the pooled prevalence of elective surgical case cancellation. Besides, it aimed to find reasons for elective surgical case cancellation in Ethiopia.Methods: The databases for the search were Web of Science, PubMed, and Google Scholar by the date 02/08/2020. To assess publication bias Egger's test regression analysis was applied. Results: This meta-analysis included a total of 5 studies with 5591 study participants. The pooled prevalence of elective surgical case cancellation was 21.41% (95% CI: 12.75 to 30.06%).Administration-related (34.50%) was the most common identified reason. Followed by Surgeon (25.29%), Medical (13.90%), and Patient-related reasons (13.34%).Conclusions: The national prevalence of elective surgical case cancellation was considerable. The most common reason for elective surgical case cancellation was administration-related reasons, followed by the surgeon, medical and patient-related reasons. The administrative or management-related reasons for the cancellations are potentially preventable. Thus, efforts should be made to prevent unnecessary cancellations through careful planning.

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“…Basic infrastructure for surgery is frequently in short supply, limiting the consistency with which healthcare facilities can provide basic surgical care42 ; as an example, running water was only available in 50% of Gambian health facilities,43 and oxygen supplies with masks and tubing were available in only 26% of Rwandan health facilities 44. High rates of delayed or cancelled procedures in LMICs have been shown to arise through both poor infrastructure45 46 and equipment shortages 46…”

Section: Need Access and Qualitymentioning

confidence: 99%

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Bath

Bashford

Fitzgerald³

2019

BMJ Glob Health

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‘Global surgery’ is the term adopted to describe a rapidly developing multidisciplinary field aiming to provide improved and equitable surgical care across international health systems. Sitting at the interface between numerous clinical and non-clinical specialisms, it encompasses multiple aspects that surround the treatment of surgical disease and its equitable provision across health systems globally. From defining the role of, and need for, optimal surgical care through to identifying barriers and implementing improvement, global surgery has an expansive remit. Advocacy, education, research and clinical components can all involve surgeons, anaesthetists, nurses and allied healthcare professionals working together with non-clinicians, including policy makers, epidemiologists and economists. Long neglected as a topic within the global and public health arenas, an increasing awareness of the extreme disparities internationally has driven greater engagement. Not necessarily restricted to specific diseases, populations or geographical regions, these disparities have led to a particular focus on surgical care in low-income and middle-income countries with the greatest burden and needs. This review considers the major factors defining the interface between surgery, anaesthesia and public health in these settings.

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High Elective Surgery Cancellation Rate in Malawi Primarily Due to Infrastructural Limitations

Cited by 33 publications

References 25 publications

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

Elective Surgical Case Cancellation and Reasons in Ethiopia: A Systematic Review and Meta-Analysis

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

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