Aguirre-Córdova JF, Chávez-Vázquez G, Huitrón-Aguilar GA, Cortés-Jiménez N

Language: Spanish
References: 24
Page: 545-551
PDF size: 73.41 Kb.

ABSTRACT

Objective: To identify the causes of cancellation of scheduled surgical procedures at a General Hospital and review of literature. Proceedings: The record of scheduled surgery was reviewed at one year. We identified frequency of cancellation and the three main sources including: hospital, medical team, and patient. Results: Scheduled surgery record registered 3627surgical procedures; 863 were cancelled. The last 4 months of the year registered the majority of cases. Nearly 60% of suspensions were in Orthopedics (26.6%), General Surgery (22.13%), Gynecology (17.84%), and Ophthalmology (10.06%). Forty percent of total cancelled surgery related with patient causes, 30% to hospital sources, and 29.8% to deficiencies of the medical team. Conclusion: Rate of scheduled surgery cancellation was 23.79%. It was most important during the last 4 months of the year. Orthopedics, General Surgery, Gynecology, and Ophthalmology were the main specialties involved. Sources of cancellation were identified as patient causes, in place; hospital deficiencies and medical team reasons shared the second place. Situational diagnosis of each hospital and a pre- surgical assessment clinic reduce rate of cancelled surgical procedures.

REFERENCES

1. Haberkern CM, Lecky JH. Preoperative assesment and the anesthesia clinic. Anesthesiol Clin NA 1996;14(4):609-627.

2. Van Norman GA. Preoperative assessment of common diseases in the outpatient setting. Anestesiol Clin North Am 1996;4:631-654.

3. Pollard JB, Olson L. Early outpatient preoperative anesthesia assessment: does it help to reduce operating room cancellations? Anesth Anal 1999;89:502-505.

4. Ault ML, Cooper SJ, Peruzzi WT. The preoperative assesment clinic, its value and function. Anesthesiol Clin NA 1997;15 (4):735-754.

5. Macarthur AJ, Macarthur C, Bevan JC. Determinants of pediatric day surgery cancellation. J Clin Epidemiol 1995;48:485-489.

6. Marcello PW, Roberts PL. Estudios preoperatorios "de rutina", selección de los más adecuados para el paciente idóneo. Clin Quir NA1996;1:11-21.

7. McGillis ST, Stanton-Hicks U. The preoperative patient evaluation: preparing for surgery. Dermatol Clin 1998;16:1-15.

8. Muñoz E, Tortella BJ, Jaker M, Sakmyster M, Kanofsky P. Surgical resource consumption in an academic health consortion. Surgery 1994;115:411-416.

9. Lacqua MJ, Evans JT. Cancelled elective surgery: an evaluation. Am Surg 1994;60: 809-811.

10. Cavalcante JB, Pagliuca LM, Almeida PC. Cancellation of scheduled surgery at a university hospital: an exploratory study. Rev Lat Am Enfermagem 2000;8 (4):59-65.

11. Hand R, Levin P, Stanziola A. The causes of cancelled elective surgery.Qual Assur Util Rev 1990;5(1):2-6.

12. Ballinger WF, Hepner JO. Total quality management and continuous quality improvement: an introduction for surgeons. Surgery 1993;113:250-254.

13. Fennely ME, Hall GM. Anaesthesia and upper respiratory tract infections: a non-existent hazard? Br J Anaesth 1990;64:535-6.

14. Cohen MM, Cameron CB. Should you cancel the operation when a child has an upper respiratory tract infection? Anesth Analg 1991;72:282-288.

15. Cote Ch J. The upper respiratory tract infection (URI) dilemma fear of a complication or litigation?. Editorial a: risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections. Tait AR, Malviya S, Voepel-Lewis T, Munro HM, Siewert M, Pandit UA. Anesthesiology 2001;95:299-306.

16. Livingstone JI, Harvey M, Kitchin N, Shah N, Wastell CH. Role of pre-admission clinics in a general surgical unit: a 6-month audit. Ann Royal Surg Eng 1993;75:211-212.

17. Vinukondaiah K, Ananthakrishnan N, Ravishankar M. Audit of operation theatre utilization in general surgery. Natl Med J India 2000;13(3):118-21.

18. Narr BJ, Hansen TR, Warner MA. Preoperative laboratory screening in healthy Mayo patients: cost-effective elimination test and unchanged outcomes. Mayo Clin Proc 1991;66:155-159.

19. Kaplan EB, Sheiner LB, Boeckmann AJ, Roizen MF, Beal SL, Cohen SN, Nicoll D. The usefulness of preoperative laboratory screening. JAMA 1985;253: 3576-3581.

20. Rusell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. Papel del análisis costo-eficacia en la salud y la medicina. JAMA 1996; 276:1;172-177.

21. Dexter F, Macario A. Applications of information systems to operating room scheduling. Anesthesiology 1996;85:1232-1234.

22. Glenn DM, Macario A. Management of the operating room. Anesthesiol Clin NA 1999;17:365-363.

23. Canales MG, Macario A, Krummel T. The surgical suite meets the new health economy. J Am Coll Surg 2001;192:768-775.

24. Dufek S, Gaucher E, Gialanella J, Kratochwil E, Learned D, Sonda P. et al. The total quality process applied to the operating room and other clinical processes. Surgery 1993;113:255- 259.