Cancellation of elective operations on the day of intended surgery at the major operating room in Tikur Anbessa specialized Hospital :Point Prevalence and reasons.
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Date
2017-11
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Addis Ababa University
Abstract
Background:Elective surgical case cancellation refers to any elective surgical case that is booked
into the operation theatre list on the day prior to surgery, but is not operated upon as scheduled.
Elective surgical case cancellation is common and can have significant adverse effects. The cancellation
of planned surgeries causes prolonged wait times, harm to patients, and is a waste of scarce resources
in countries like Ethiopia. Cancellation of scheduled surgery leads to operating theatre under-occupancy
and is recognized as a major cause of emotional trauma to patients and their families.
Reasons for cancellations are complex and many; they are as unique as they are similar.
Objective:To determine the point prevalence of elective surgical case cancellations and the reasonsat
the major OR in TikurAnbessa specialized hospital from June 1 to October 31, 2017 G.C.
Method:This was a prospective cross sectional study of the operation theatre list over a period of five
months (June 1,2017-October 31, 2017). All patients scheduled to undergo elective surgeries at the
major OR of the hospital from June-October 2017 were included. Data was collected by using pretested
structured questionnaires and an assigned OR staff was recording the cancelled cases in real time. The
assigned staff has confirmedthe cancellation reason and added additional necessary explanation.
Data wasentered in to SPSS version 20 for analysis. The result of study was explained by narratives,
tables andgraphs.
Results:For the given study period, 1904 elective surgeries were scheduled to be performed at the
major OR of TASH, of which 627 cases (32.9 %) were cancelled on the day of surgery. The average age
was 37 years, with male to female cancellation ratio of 1.07:1. The main reasons for cancellation were
management/facility related (45.9%), shortage of time related (31.4%), and Workup/medical
conditionrelated (9.7%). Neurosurgery experienced the most cancellations (27.4%), followed by general
surgery (16.3%).
Conclusion: This study found out that the cancellation of elective surgical operation on the
scheduled day of surgery was very significant. Most of the reasons were deemed avoidableand
commonest were management/facility related followed by shortage of time related.
Recommendation:Determining an easily avoidable contributors to the cancellations is an essential
first step to developing appropriate interventions to improve OR efficiency.Implementation of patient
preoperative assessment should be applied. A team approach ensuring presence of policies and
procedures for improving and ensuring realistic scheduling of patient lists, reducing time spent
preparing and cleaning the operating room and better handling resources should be applied.
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Keywords
Day of surgery Cancellations, Elective surgical operations