Cancellation of Surgeries: Integrative Review

Talalwah, Narmeen Al; McIltrot, Kimberly

doi:10.1016/j.jopan.2017.09.012

Cited by 79 publications

(73 citation statements)

References 22 publications

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“…Although the seasonal disruption of surgical care and the occasional cancellation of surgery is not new to most healthcare systems, the current pandemic has unprecedented implications for surgical services and patients with surgical conditions. Surgical capacity may experience extreme challenges in war zones, or in the case of mass casualty events from terror or during civilian accidents or natural disasters, with numbers exceeding the surgical capacity (such as operating theatres, number of surgeons and anaesthesia staff).…”

Section: Introductionmentioning

confidence: 99%

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Søreide

Hallet

Matthews

et al. 2020

British Journal of Surgery

599

564

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Background: The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other services, including delivery of surgery. Methods: This was a scoping review of all available literature pertaining to COVID-19 and surgery, using electronic databases, society websites, webinars and preprint repositories. Results: Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross-cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning. Conclusion: Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.

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Section: Introductionmentioning

confidence: 99%

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Søreide

Hallet

Matthews

et al. 2020

British Journal of Surgery

599

564

View full text Add to dashboard Cite

show abstract

“…In theory, 29 (64 per cent) of the 45 late cancellations in the present study were potentially preventable by more precise waiting‐list scheduling, staff allocation or thorough tailored pre‐evaluations (4 patients did not need an operation, and 3 did not show). Acute infection and acute exacerbation of chronic disease, which occurred in 16 of the 45 patients with a late cancellation, cannot be anticipated, but healing, for example, could be predetermined by telephone contact before surgery or during the re‐evaluation process before the day of surgery. Two‐thirds of the late cancellations were due to preventable reasons, the most common being scheduling difficulties.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

et al. 2020

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Background: The 23-h surgery model consists of elective operative care with an overnight hospital stay for patients unsuitable for day case surgery. The aim of this study was to assess the success of the 23-h surgery model. Methods:This was a prospective follow-up study of patients undergoing surgery with the planned 23-h model in a tertiary-care university hospital during a 12-month period 2 years after the model was implemented. Patients were interviewed 2 weeks after surgery, and the hospital operative database and patient records were searched. The primary outcome was the success of the process, defined as discharge before 10.00 hours on the first morning after surgery. Secondary outcomes were 30-day readmission and reoperation rates, adverse events, and patient satisfaction with the process. Results: Between May 2017 and May 2018, 993 adult patients underwent surgery with the 23-h model, of whom 937 adhered to the model as planned (success rate 94⋅4 per cent). Gynaecological, gastrointestinal and orthopaedic surgery were the three most common surgical specialties. The surgical process was changed to an in-hospital model for 45 patients (4⋅5 per cent), and 11 (1⋅1 per cent) were discharged on the day of surgery. The readmission rate was 1⋅9 per cent (19 of 993), and five patients (0⋅5 per cent) had a reoperation within 30 days of surgery. Fifty-nine adverse events were noted in 53 patients (5⋅3 per cent), most commonly infection. Patient satisfaction was a median of 6-7 (maximum 7) points for various aspects of the model. Conclusion: The success rate and patient satisfaction for the 23-h surgery model was high.

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“…In addition, reasons for late cancellations varied for patients undergoing skull base vs inflammatory and inpatient vs outpatient surgery in our population, highlighting the need for focused interventions to minimize specific causes for cancellations in these patients. As preoperative clinic visits have been proven to medically optimize patients before surgery and thus minimize surgical cancellations, we are considering having our patients, particularly skull base patients, complete their preoperative visits closer to their surgery date (such as within 2 weeks of surgery) rather than further out, in an effort to recognize any changes in medical status and minimize late cancellations related to medical/work‐up issues . If there are concerns regarding insurance issues, patients can also meet with our financial coordinators during this visit, thus minimizing potential cancellations due to financial/administrative delays.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative phone contact been shown to be very effective in reducing late cancellation rates. De Avila et al attributed the significant reduction in cancellation rate, from 18% to 5.4%, to preoperative phone calls, whereas Kaye et al reported not only reduced cancellations rates but also a defined decrease in patient no‐show rates, from 26% to 10.8% . A preoperative phone call 1 week before surgery to ensure that the patient is aware of the scheduled surgery and that there are no barriers to arriving on the day of surgery, such as transportation issues or current illnesses, may help avoid late cancellations attributable to patient logistical factors or acute medical illnesses, such as an upper respiratory infection or pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 24‐hour surgical cancellations in an academic rhinology and skull base surgery practice

Roxbury

Shah

Tang

et al. 2018

Int Forum Allergy Rhinol

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Background: Late cancellations within 24 hours of surgery lead to decreased utilization of operating room time with loss of productivity, decreased access to care, and inconvenience to patients and staff. To date, no studies have analyzed 24-hour cancellations in a tertiary rhinology practice. Methods:All procedures performed at a tertiary rhinology/skull base practice from January 2016 to December 2017 were reviewed. Twenty-four-hour cancellations were analyzed by procedure type and reason for cancellation. Avoidable cancellations were late cancellations that could have been prevented by review of medical records or communication by hospital staff with the patient before surgery. Univariate analysis was performed to determine predictive factors for cancellations. Results:A total of 39 of 640 surgical cases were cancelled (6.1%) within 24 hours of surgery. Of these, 69.2% were inflammatory and 30.8% were skull base cases. The mean number of operating room minutes lost was 151 (60 of 210) for inflammatory and 263 (102 of 480) for skull base cases. Avoidable cancellations were seen in 25 of 35 (71.4%) cases. Patients undergoing inpatient or skull base surgery were more likely to have medical cancellations than patients undergoing outpatient or inflammatory surgery (91.7% vs 43.5%, p = 0.01; 83.3% vs 47.8%, p = 0.07).Conclusion: This is the first study to analyze 24-hour cancellations in tertiary rhinology/skull base surgery. The results suggest that a majority of late cancellations are avoidable and that skull base and inpatient surgeries are more likely to be canceled for medical reasons. Further studies are required to be er characterize surgical cancellations in rhinology and identify strategies to try to prevent them. C 2018 ARS-AAOA, LLC. How to Cite this Article: Roxbury CR, Shah J, Tang D, et al. Analysis of 24-hour surgical cancellations in an academic rhinology and skull base surgery practice. Int Forum Allergy Rhinol. 2019;9:298-304.L ate or same-day surgical cancellations, defined as cancellations occurring within 24 hours of scheduled

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Cancellation of Surgeries: Integrative Review

Cited by 79 publications

References 22 publications

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

Analysis of 24‐hour surgical cancellations in an academic rhinology and skull base surgery practice

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