Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital

BMC Surgery

Research Article

Li Luo¹  Kaiye Yu²  Xiaolei Xie²  Renrong Gong³ 

[1] Department of Industrial Engineering and Engineering Management, Service Management Institute, Business School of Sichuan University, Chengdu, China;Department of Industrial Engineering, Tsinghua University, Beijing, China;Operating Room Department, West China Hospital, Sichuan University, Chengdu, China;

关键词: Case cancellation;    Contributing factors;    Operating room efficiency;    Quality improvement;   

DOI  :  10.1186/s12893-017-0296-9

 received in 2017-04-13, accepted in 2017-09-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCase cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention.MethodWe conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors.ResultsCC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays.ConclusionsWorkup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.

【 授权许可】

CC BY   
© The Author(s). 2017