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Patient Safety in Surgery
Published in: Patient Safety in Surgery 1/2018

Open Access 01-12-2018 | Research

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

Authors: Melaku Desta, Addissu Manaye, Abiot Tefera, Atalay Worku, Alemitu Wale, Alemlanchi Mebrat, Negesso Gobena

Published in: Patient Safety in Surgery | Issue 1/2018

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Abstract

Background

Elective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological trauma to patients and their families. Despite little is known in Ethiopia. Therefore, this study aimed to assess incidence and reasons of cancellations of elective operation on the intended day of surgery at tertiary referral academic medical center in Ethiopia.

Methods

A prospective hospital-based cross-sectional study design was conducted in a tertiary referral academic medical center in Ethiopia among 146 participants. A self-administered questionnaire with an observatory checklist was used for collecting data from the anesthetist, nurse, and surgeons.

Result

In this study, 462 patients were scheduled for elective surgical operations. Among those, nearly almost one-third 146 (31.6%) of the operations were cancelled and 316 (68.4%) patients were operated on their planned date. The most common reason for cancellation were surgeon related (35.8%), patient related (28.7%), management related (21.2%) and anesthesia related factors (14. 4%). The cancellation was mainly due to improper scheduling (20.5%%), unavailability of surgeons (8.9%), unavailability of oxygen and blood (8%) and equipment (5.5%). Orthopedic (28.8%) and general surgery (17.1%) were the commonest cancelled cases.

Conclusion

The cancellation rate in our academic medical center remains high. Improper scheduling, unavailability of surgeons, medical illness, and unavailability of operating room equipment were the commonest reason for the cancellation of elective operation. Most cancellations were preventable. For this, proper preoperative assessment, proper scheduling, fulfilling necessary operating room equipment’s and cross-matched blood by the hospital and other stakeholders, early clear communication with operating room team like surgeons was recommended.
Literature
1.
Ebirim LN, Buowari DY, Ezike H. Causes of cancellation of elective surgical operations at a University Teaching Hospital. J Med Med Sci. 2012;3(5):297–301.
2.
Argo JL, Vick CC, Graham LA, Itani KM, Bishop MJ, Hawn MT. Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement. Am J Surg. 2009;198(600):6.
3.
Schofield WN, Rubin GL, Piza M, Lai YY, Sindhusake D, Fearnside MR, et al. Cancellation of operations on the day of intended surgery at a major Australian referral hospital. Med J Aust. 2005;182(12):612–5.PubMed
4.
Kaddoum R, Fadlallah R, Hitti E, El-Jardali F, El Eid G. Causes of cancellations on the day of surgery at a Tertiary Teaching Hospital. BMC Health Serv Res. 2016;16:259.CrossRefPubMedPubMedCentral
5.
Abeeleh MA, Tareef TM, Hani AB, Albsoul N, Samarah OQ, ElMohtaseb MS, et al. Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement. Ann Surg Treat Res. 2017;93(2):65–9.CrossRefPubMedPubMedCentral
6.
Chiu CH, Lee A, Chui PT. Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: point prevalence and reasons. Hong Kong Med J. 2012;18(1):5–10.PubMed
7.
Dhafar KO, Ulmalki MA, Felemban MA, Mahfouz ME, Baljoon MJ, Gazzaz ZJ, et al. Cancellation of operations in Saudi Arabian hospitals: Frequency, reasons and suggestions for improvements. Pak J Med Sci. 2015;31(5):1027–32.CrossRefPubMedPubMedCentral
8.
Sung WC, Chou AH, Liao CC, Yang MW, Chang CJ. Operation cancellation at Chang Gung Memorial Hospital. Chang Gung Med J. 2010;33(5):568–75.PubMed
9.
Santos GAAC, SCM B. Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction. Rev Bras Enferm. 2017;70(3):535–42.CrossRefPubMed
10.
Elrahman AA, Hamza AA, EL-Haj MA. Cancellation of Elective General Surgical Operations at the Day of Intended Surgery Global Journal of HUMAN-SOCIAL SCIENCE: I Surgeries and Cardiovascular System 2014;14(3).
11.
Mutwali IM, Abbass AM, Elkheir IS, Arbab SS, Bur A, Geregandi T. Cancellation of elective surgical operations in a teaching hospital at Khartoum Bahri, Sudan. Sudan Med Monit. 2016;11(2):196.1.28.51.CrossRef
12.
Chalya PL, Gilyoma JM, Mabula JB, Simbila S, Ngayomela IH, Chandika AB, et al. Incidence, causes and pattern of cancellation of elective surgical operations in a university teaching hospital in the Lake Zone, Tanzania. Afr Health Sci. 2011;11(3):438–43.PubMedPubMedCentral
13.
Lankoandea M, Bonkoungoub P, Traorea S, Kaborea R, Ouangrec E, Pendeville P. Cancellation of elective surgical procedures in the university teaching hospital center Yalgado Ouedraogo in Burkina Faso: incidence, reasons and proposals for improvement. South Afr J Anaesth Analg. 2016;22(5):140–4.
14.
Prin M, Eaton J, Mtalimanja O, Charles A. High Elective Surgery Cancellation Rate in Malawi Primarily Due to Infrastructural Limitations. World J Surg. 2018;42(6):1597–602.CrossRefPubMed
15.
Mulira M, Smith MD, Moorman J. Factors Contributing To Elective Theatre Cancellations In The Department Of Surgery At Chbah. South Afr J Surg Suid-Afrikaanse tydskrif vir chirurgie. 2017;55(2):66–7.
16.
Leslie RJ, Beiko D, van Vlymen J, Siemens DR. Day of surgery cancellation rates in urology: Identification of modifiable factors. Can Urol Assoc J. 2013;7(5–6):167–73.CrossRefPubMedPubMedCentral
17.
Yu K, Xie X, Luo L, Gong R. Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital. BMC Surg. 2017;17(1):100.CrossRefPubMedPubMedCentral
18.
Dexter F, Blake JT, Penning DH, Lubarsky DA. Calculating a potential increase in hospital margin for elective surgery by changing operating room time allocations or increasing nursing staffing to permit completion of more cases: a case study. Anesth Analg. 2002;94(1):138–42.PubMed
19.
Mangan JL, Walsh C, Kernohan WG, Murphy JS, Mollan RA, McMillen R, et al. Total joint replacement: implication of cancelled operations for hospital costs and waiting list management. Qual Health Care. 1992;1(1):34–7.CrossRefPubMedPubMedCentral
20.
Perroca MG, Jerico Mde C, Facundin SD. Surgery cancelling at a teaching hospital: implications for cost management. Rev Lat Am Enfermage. 2007;15(10):18–24.
21.
Van Klei WA, Moons KGM, Rutten CL, Schuurhuis A, Knape JTA, Kalkman CJ, et al. The effect of outpatient preoperative evaluation of hospital inpatients on cancellation of surgery and length of hospital stay. Anesth Analg. 2002;94(3):644–9.CrossRefPubMed
22.
Association HFM. Achieving operating room efficiency through process integration. Healthc Financ Manage. 2003;57(3):suppl 1-7 following 112.
23.
Tait AR, VoepelLewis T, Munro HM, Gutstein HB, Reynolds PI. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. J Clin Anesth. 1997;9(3):213–9.CrossRefPubMed
24.
Lee A, Kerridge RK, Chui PT, Chiu CH, Gin T. Perioperative Systems as a quality model of perioperative medicine and surgical care. Health Policy. 2011;102:214–22.CrossRefPubMed
25.
McKendrick DR, Cumming GP, Lee AJ. A 5-year observational study of cancellations in the operating room: Does the introduction of preoperative preparation have an impact? Saudi JAnaesth. 2014;8(Suppl 1):S8–s14.CrossRef
26.
Farasatkish R, Aghdaii N, Azarfarin R, Yazdanian F. Can preoperative anesthesia consultation clinic help to reduce operating room cancellation rate of cardiac surgery on the day of surgery? Middle East J Anaesthesiol. 2009;20(1):93–6.PubMed
27.
Epstein RH, Dexter F. Management implications for the perioperative surgical home related to inpatient case cancellations and add-on case scheduling on the day of surgery. Anesth Analg. 2015;121(1):206–18.CrossRefPubMed
28.
Kumar R, Gandhi R. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital. J Anaesthesiol Clin Pharmaco. 2012;28:66–9.CrossRef
29.
Haile M, Desalegn N. Prospective Study of Proportions and Causes of Cancellation of Surgical Operations at Jimma University Teaching Hospital, Ethiopia. Int J Anesth Res. 2015;3(2):87–90.
30.
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(9):374–8.PubMed
31.
Von Elm E, Altman D, Egger M, Pocock S, Gøtzsche PJV. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 2007;85:867–72.CrossRefPubMedPubMedCentral
32.
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(1):35–9.PubMedPubMedCentral
33.
Schuster M, Neumann C, Neumann K, Braun J, Geldner G, Martin J, et al. The effect of hospital size and surgical service on case cancellation in elective surgery: results from a prospective multicenter study. Anesth Analg. 2011;113(3):578–85.PubMed
34.
Arshad Z, Tariq M, Samson G, Sajjad A. Cancelled elective general surgical operations in ayub teaching hospital. J Ayub Med Coll Abbottabad. 2007;19(3):66.
35.
El-Dawlatly A, ATurkistani, Aldohayan A, Zubaidi A, Ahmed A. Reasons of Cancellation of Elective Surgery in A Teaching Hospital. Int J Anesthesiol. 2007;15:2.
36.
Laisi J, Tohmo H, Keränen U. Surgery Cancelation on the Day of Surgery in Same-Day Admission in a Finnish Hospital. Scand J Surg. 2013;102:3204–8.CrossRef
Metadata
Title
Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia
Authors
Melaku Desta
Addissu Manaye
Abiot Tefera
Atalay Worku
Alemitu Wale
Alemlanchi Mebrat
Negesso Gobena
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2018
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/s13037-018-0171-3

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