Analysis of 43 Intraoperative Cardiac Surgery Case Cancellations

Fitzsimons, Michael G.; Dilley, Joshua D.; Moser, Chris; Walker, Jennifer D.

doi:10.1053/j.jvca.2015.08.007

Cited by 22 publications

(34 citation statements)

References 13 publications

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“…A study of cardiac surgical case cancellations in Massachusetts indicated that 0.84% of such surgeries were cancelled after the patient had entered the cardiac surgical operating room [6]. In our study, the cancellation rate was less than 0.01%, which was relatively low.…”

Section: Discussioncontrasting

confidence: 54%

Surgery cancellations after entering the operating room

2016

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BackgroundSurgery cancellation results in unavailability of the operating room and loss time. We identified the frequency of and reasons for operation cancellations after patients entered the operating room and assessed the preventability of such cancellations.FindingsA retrospective chart review of all scheduled surgical procedures proposed under general anesthesia in a period spanning 2008 to 2016 was performed, and the reasons for cancellation were assessed.A total of 30 surgery procedures were cancelled after the patient had entered the operation room and preparation for general anesthesia had been completed. Ten of 18 cases (55.6%) that were cancelled before general anesthesia induction could have been prevented, accounting for 36.7% of the overall cancellations. The majority of the cancellations after anesthesia were due to the patients’ health status.ConclusionsImproving the systems for checking patients’ medical problems and performing preoperative evaluations can reduce the number of cancellations after the patient has entered the operating room.

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Section: Discussioncontrasting

confidence: 54%

Surgery cancellations after entering the operating room

2016

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“…Surgery cancelation is 1 of the uncertain factors and occurs in many hospitals, the rate of which ranges from 0.84% to 30.3%. Shi et al indicate that possible surgery cancelations derived from data mining and nonelective surgeries should be considered during scheduling.…”

Section: Introductionmentioning

confidence: 99%

A random forest and simulation approach for scheduling operation rooms: Elective surgery cancelation in a Chinese hospital urology department

Luo

Feng

Zhao

et al. 2018

Health Planning & Management

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Many hospitals encounter surgery cancelations for various reasons. We present a methodology applying data mining and simulation to optimize operating room (OR) scheduling in a urology department in West China Hospital. To the best of our knowledge, this is 1 of the first efforts to seek an optimal schedule solution based on cancelation risk of elective surgeries as well as OR allocation between elective and nonelective surgeries. First, chi-square test and random forest prediction modeling were used to predict potential elective surgeries with high cancelation risk, and the factors, including surgeon, number of days since admission of patient, first surgery or not, etc., that influence elective surgery cancelation were identified. Second, a simulation technology was designed to compare 7 different scheduling strategies. The results demonstrated that for elective surgery, cancelation rate low surgery first outperformed the others and increased the productivity of the ORs from 72% to 83%, while for nonelective surgery performed in a separate OR, there was no improvement because the supply was greater than necessary at present. However, in total, the selected strategies led to 7% higher productivity.

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“…According to the United States Department of Veteran's Affairs (VA), in 2006, it was estimated that the financial loss of a 1.4% cancellation rate was more than 32 million US dollars (Argo et al., ). In the United States, the average cost of unstaffed operating room time is 62 US dollars/min (Fitzsimons et al., ). The largest costs of cancelled surgeries after the preparation of the surgery room and during the surgery itself are related to human resources (62.8%) (Perroca, Jerico Mde, & Facundin, ).…”

Section: Introductionmentioning

confidence: 99%

“…Cancellations are a problem in perioperative care, and most of them are preventable (Kumar & Gandhi, 2012). It has been estimated that 50%-65% of cancellations could be potentially avoided (Chughtai, Michael, & Qurashi, 2014;Fitzsimons, Dilley, Moser, & Walker, 2016;Kim & Lee, 2014). In this study, day of surgery cancellation (DOS) is defined as a scheduled elective operative procedure that was cancelled on the same day it was planned to occur.…”

Section: Introductionmentioning

confidence: 99%

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The impact of a structured preoperative protocol on day of surgery cancellations

Turunen

Miettinen

Setälä

et al. 2017

Journal of Clinical Nursing

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Aims and objectives:To evaluate the impact of implementing an evidence-based, structured preoperative protocol on day of surgery cancellations in 13 operative specialties.Background: Surgery cancellations cause unnecessary harm for patients and organisations as many cancellations could be prevented. Preoperative care has developed in recent years, and several preoperative interventions have been introduced. However, the optimal model for organising preoperative care remains unknown. Cancellations are a commonly used indicator when evaluating the success of preoperative care.Design: Observational study with two study phases: before and after.Methods: The cancellation data were collected from the hospital register from 1September 2013-31 May 2014 (n = 591) and from September 2015-May 2016(n = 542). The compliance rate of the preoperative protocol was evaluated in group sessions (n = 13) during spring 2016 using the participation of preoperative healthcare professionals (n = 49). The data were analysed statistically.Results: Cancellation rates varied between 1.6%-9.7% (in the first phase) and between 1.5%-7.7% (in the second phase). A remarkable decrease was found in patients who failed to attend their scheduled procedures. The mean of compliance to the preoperative protocol across all specialties was 82.3%. A correlation between the rate of cancellation and the rate of compliance with the preoperative protocol was found.Conclusions: A preoperative protocol promotes the scheduled arrival of surgical patients to the hospital and therefore decreases cancellation rates.Relevance to clinical practice: An evidence-based preoperative care protocol should be introduced for all healthcare professionals working in preoperative care to ensure smooth, safe and high-quality care for surgical patients. | INTRODUCTIONCancellations are a problem in perioperative care, and most of them are preventable (Kumar & Gandhi, 2012). It has been estimated that 50%-65% of cancellations could be potentially avoided (Chughtai, Michael, & Qurashi, 2014;Fitzsimons, Dilley, Moser, & Walker, 2016;Kim & Lee, 2014). In this study, day of surgery cancellation (DOS) is defined as a scheduled elective operative procedure that was cancelled on the same day it was planned to occur. DOS cancellations are described to be one of the 23 nursing-sensitive quality indicators for evaluating and monitoring efficiency, patient safety and crisis event management in perioperative care (Wu et al., 2017 The largest costs of cancelled surgeries after the preparation of the surgery room and during the surgery itself are related to human resources (62.8%) (Perroca, Jerico Mde, & Facundin, 2007).In tertiary care paediatric outpatient surgical centres, the cost of a cancelled urology patient was 4,802 US dollars, which led to an approximately 500,000 dollar loss over a 7-month period with a cancellation rate of 13.3% (Pohlman, Staulcup, Masterson, & Vemulakonda, 2012). Calculating the actual overall cost of cancellations is complicated because of the variations in care ...

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Analysis of 43 Intraoperative Cardiac Surgery Case Cancellations

Cited by 22 publications

References 13 publications

Surgery cancellations after entering the operating room

Surgery cancellations after entering the operating room

A random forest and simulation approach for scheduling operation rooms: Elective surgery cancelation in a Chinese hospital urology department

The impact of a structured preoperative protocol on day of surgery cancellations

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