DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20150897

Causes of cancellation for elective orthopedic procedures on the day of surgery

Asmita Karnalkar, Pratap Karnalkar

Abstract


Background: A retrospective observational study was conducted to find out the reasons for cancellation of elective orthopedic surgical inpatients on the day of surgery and to plan for future suggestive actions to decrease unnecessary cancellations.

Methods: This was a retrospective observational study conducted at medical teaching hospital for 3 years from January 1, 2012 to December 31, 2014. The data was collected from postponement register. The files of cases that were cancelled were reviewed for the reasons of cancellations. The reasons were classified as anaesthetist related, administrative issues, surgeon related and patient related issues.

Results: During the study period, 7673patients were posted for elective orthopedic procedures. 6.49 % patients were cancelled on the day of surgery. The frequency of cancellations was more in anesthetist related issues (38.9%). Cancellations due to administrative issues, patient related issues and surgeon related were 30%, 27.7% & 3.4% respectively.

Conclusions: Although cancellations were only 6.49% of total elective operations, this can be reduced by implementing and following the recommendations that have been proposed. More thorough and detailed documentation is needed to achieve this.


Keywords


Elective orthopedic procedures, Anesthetist related issues, Cancellations

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References


Schofield WN, Rubin GL, Piza M, Lai YY, Sindhusake D, Fearnside MR, et al. Cancellations on the day of intended surgery at a major Australian referral hospital. Med J Aust. 2005;182:612-5.

Pandit JJ, Carey A. Estimating the duration of common elective operations: implications for operating list management. Anesthesia. 2006;105:237-40.

Ivarsson B, Kimblad PO, Sjberg T, Larsson S. Patient reactions to cancelled or postponed heart operations. J Nurs Manag. 2002;10:75-81.

Dix P, Howell S. Survey of cancellation rate of hypertensive patients undergoing anaesthesia and elective surgery. Br J Anaesth. 2001;86:789-93.

Aaserud M, Trommald M, Boynton J. Elective surgery - cancellations, ring fencing and efficiency. Tidsskr Nor Laegeforen. 2001;121:2516-9.

Pollard JB, Olson L. Early outpatient preoperative anaesthesia assessment: does it help to reduce operating room cancellations? Anesth Analg. 1999;89:502-25.

Koppada B, Pena M, Joshi A. Cancellation in elective orthopaedic surgery. Health Trends. 1991;23:114-5.

Wildner M, Bulstrode C, Spivey J, Carr A, Nugent I. Avoidable causes of cancellation in elective orthopaedic surgery. Health Trends. 1991;23:115-6.

Macarthur AJ, Macarthur C, Bevan JC. Determinants of pediatric day surgery cancellation. J Clin Epidemiol. 1995;48:485-9.

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

Jorgensen LN, Hinrichsen NC, Kristensen NK, Kramhoft J. Cancelled surgical interventions at an orthopedic department. Ugeskr Laeger. 1991;153:1657-8.

Thompson PJ. A current problem in oral and maxillofacial surgery. Br Dent J. 1991;171:244-5.

Down MP. The anesthesia consults clinic: does it matter which anesthetist see the patient? Can J Anesth. 1998;45:802-8.

Starsnic MA, Guarnieri DM, Norris MC. Efficacy and financial benefit of an anaesthesiologist-directed university preadmission evaluation center. J Clin Anesth. 1997;9:299-305.

Lacqua MJ, Evans JT. Cancelled elective surgery: an evaluation. Am Surg. 1994;60:809-11.

Lee A, Chui PT, Chui CH. Perioperative system as a quality model of perioperative medicine and surgical care. Health Policy. 2011;102:214-22.

Dufec S, Gaucher E. The total quality process applied to the operating rooms and other clinical processes. Surgery. 1993;113:255-9.

Havlid E, Von Plesson C. Patient experiences with interventions to reduce. BMC Surg. 2013;13:30.

Charalambous CP, Paschalides K, Gunedran T, Tryfonidis M, Hirst P. Availability of orthopedic trauma lists in U.K. Injury. 2005;36:1156-8.

Macario A. Are your hospital operating rooms “efficient”? A scoring system with eight performance indicators. Anesthesiology. 2006;105:237-40.

Ulla Cesar, Jon Carlson, Lars-Eric Olsson, Kristian Samuelsson, Elisabeth Hansson-Olofsson. Incidence and root causes of cancellations for elective orthopedic procedures. Patient Saf Surg. 2014;8:24-30.

Farhanul Huda. Retrospective analysis of reasons for cancellations of elective surgery in teaching hospital. Int J Sci Study. 2014;2:28-30.

Eijkemans MJ, van Houdenhoven M, Nguyen T, Boersma E, Steyerberg EW, Kazemier G. Predicting the unpredictable: a new prediction model for operating room time. Anesthesiology. 2010;112:41-9.

Afar A, Mufti TS, Griffin S, Ahmed S, Ansari JS. Cancelled elective general surgical operation in Ayub teaching hospital. J Ayub Med Coll Abbottabad. 2007;19:64-6.

Garg R, Bhalotra AR, Bhadoria P, Gupta N, Anand R. Reasons for cancellation of cases on the day of surgery: a prospective study. Indian J Anaesth. 2009;53:35-9.

Hanss R, Buttgereit B, Tonner PH, Bein B, Schleppers A, Steinfath M, et al. Overlapping induction of anesthesia: an analysis of benefits and costs. Anesthesiology. 2005;103:391-400.

Basson MD, Butler T. Evaluation of operating room suite efficiency in the Veterans Health Administration system by using data-envelopment analysis. Am J Surg. 2006;192:649-56.

Pollard JB, Zboray AL, Mazze RI. Economic benefits attributed to opening a preoperative evaluation clinic for outpatients. Anesth Analg. 1996;83:407-10.

Hussain AM, Khan FA. Anaesthetic reasons for cancellation of elective surgical inpatients on the day of surgery in a teaching hospital. J Pak Med Assoc. 2005;55:374-8.