Reasons for cancellations of urologic day care surgery

Abstract

Objective: The numerous economic and social benefits associated with the practice of day care surgery could be eroded by frequent cancellations. We therefore determined the reasons for such cancellations in a tertiary care centre in Nigeria. Patients and Methods:This was a prospective study of all consecutive urologic day cases seen at Jos University Teaching hospital, Nigeria from January 2003 to December 2004. Results: A total of 270 patients were seen during the study period with ages from 2 weeks to 100 years (median 55 years) and male to female ratio of 14:1. The procedures carried out were mainly urethroscopy /urethrocystoscopy in 103 (38.2%) patients, visual internal urethrotomy in 48 (17.8%) and trucut prostatic biopsy in 33 (12.2%) patients. Sixteen (5.9%), 16(5.9%), 9(3.3%) and 8(3.0%) patients had examination under anaesthesia / bladder biopsy for suspected bladder carcinoma, urethral dilatation, testicular biopsy and total orchidectomy for carcinoma of the prostate respectively. There was a cancellation rate of 15.6% (n=42) mainly due to the inability of the patients to come (24 patients, 57.1%), inadequate materials in the theatre (9 patients, 21.4%), power failure (4 patients, 9.5%), strike action (3 patients, 7.1%) and financial difficulties (2 patients, 4.8%). Conclusion:We are still faced with a high cancellation rate of urologic day cases and these are mainly due to avoidable reasons. Patient as well as physician education and provision of adequate materials and infrastructural development are recommended to reduce these; so as to gain maximally from urologic day surgery practice.

Orthopaedics in day surgery

“…The commonest found in most of the public hospitals is where day surgery patients share wards and theatres with admitted patients. This renders day cases liable to missing theatre and is the most inefficient of the systems (2,3). The second is that adopted in some of the private hospitals where there are separate wards and theatres for day cases.…”

The surgical waiting time initiative: A review of the Nigerian situation

“…A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria 78910111213141516171819202122232425262728293031323334353637383940414243. A total of 11 publications (29.7%) were related to emergency surgery waiting times,7891011121314151617 10 (27%) were related to clinic waiting times,32333435363738394041 9 (24.3%) were related to day case surgery,232425262728293031 2 (5.5%) were related to investigation waiting times4243 and only 5 (13.5%) articles were specifically published on elective surgery waiting times 1819202122.…”

“…A total of 11 publications (29.7%) were related to emergency surgery waiting times,7891011121314151617 10 (27%) were related to clinic waiting times,32333435363738394041 9 (24.3%) were related to day case surgery,232425262728293031 2 (5.5%) were related to investigation waiting times4243 and only 5 (13.5%) articles were specifically published on elective surgery waiting times 1819202122. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ENT, 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery.…”

“…Furthermore, 9/37 (24.3%) of the publications were related to day surgery practice in Nigeria;232425262728293031 and most of the authors highlighted the increasing role of day surgery in facilitating and even ring-fencing elective surgeries in order to prevent or reduce frequent cancellations in favour of emergency cases [Tables 1 and 5],232425262728293031 and 2/37 (5.5%) of the published articles were related to investigation waiting times [Tables 1 and 7]. However, none of these articles specifically focused on elective or planned surgical waiting times as well as the need for an organised initiative to improve the waiting times for non-urgent surgical intervention in Nigeria.…”

Prospective Study of Proportions and Causes of Cancellation of Surgical Operations at Jimma University Teaching Hospital, Ethiopia

“…The reported incidences for elective surgery cancellation vary widely among institutions from 10-40% [4,7,8,[19][20][21].…”