IJCRR - 6(24), December, 2014
ELECTIVE SURGICAL CASE CANCELLATION - AN AUDIT
Author: Nikhil Nanjappa B. A., Kirti Katherine Kabeer, S. Robinson Smile
Background: Elective surgical case cancellation refers to any surgical case that is booked into the operation theatre list on the day prior to surgery, but is not operated upon as scheduled . The reasons for cancellation of elective surgical cases are many; they are as unique as they are similar. Aims and Objectives: The study aims to assess the magnitude of elective case cancellation at our hospital. This study tries to delineate the reasons for elective case cancellations across all surgical departments. The study aims to suggest necessary steps to alleviate the problem. Methodology: This is a prospective observational hospital based audit done between 23rd February 2012 and 5th May 2012. Observations and Results: The total number of elective cases booked into the operative list during the study period was 725, of which 197 (27.2%) was cancelled on the day of surgery. General surgery had the highest percentage share of total cancellations at 54.8%, followed by obstetrics gynecology (16.2%), orthopedics (13.1%), ENT (9.1%), urology (3.5%), pediatric surgery (2%), CTVS and neurosurgery (0.5% each). There were 9 cases that were cancelled more than once. They commonest reason for case cancellation was list over run (73%), followed by lack of patient fitness (14%). Discussion: Case cancellations on the day of surgery lead to underuse of OT’s, increases waiting period for the patients, frustration and mental stress to the patients and their families, and increases cost and wastage of hospital consumables [1-6]. Cancellation of booked elective surgeries is a common problem across all hospitals in our country and around the world. The incidence of cancellation of elective surgical operations has been reported in literature to range from 20% to 40% [3, 5, 7-10]. Improving the scheduling and admission procedure is of paramount for better use of hospital resources .
Keywords: Surgical case, CTVS, Neurosurgery
Nikhil Nanjappa B. A., Kirti Katherine Kabeer, S. Robinson Smile. ELECTIVE SURGICAL CASE CANCELLATION - AN AUDIT International Journal of Current Research and Review. 6(24), December, 19-23
1. Dawlatly AA, Turkistani A, Aldohayan A, Zubaidi A, Ahmed A. Reasons of Cancellation of Elective Surgery in a Teaching Hospital. Intern J Anesthesiol. 2008;15:2.
2. Zafar A, Mufti TS, Griffin S, Ahmed S, Cancelled elective general operations in Ayub Teaching hospital. J. Ayub Med Coll Abbollabad 2007; 19 (3): 64-66.
3. Robb WB, O’Sullivan MJ, Brannigan AE, Bouchier-Hayes DJ. Are elective surgical operations cancelled due to increasing medical admissions? Irish J Med Sci. 2004;173(3):129.
4. Miller GG. Waiting for an operation: parent’s perspectives. Can J Surg 2004; 47(3):167-9. and Kolawole I.K., Bolaji B.O. Reasons for cancellation of elective surgery in Ilorin. Nig .J Surg. Res 2002; 4 (1-2): 28-33.
5. Ojo E.O., Ihezue C.H. An Audit of Day Case Cancellations In A Nigerian Tertiary Hospital Based Day Case Unit East and Central African Journal of Surgery 2008; 13 (2); 150- 153.
6. Kolawole I.K., Bolaji B.O. Reasons for cancellation of elective surgery in Ilorin. Nig .J Surg. Res 2002; 4 (1-2): 28-33.
7. Lacqua MJ, Evans JT. Cancelled elective surgery: an evaluation. American Surgeon 1994;60:809-11.
8. Rai M, Pandit JJ. Day of surgery cancellation after nurse led pre-assessment in an elective surgical centre: the first 2 years. Anesthesia 2003; 58:692-9.
9. Dakum N. K., Ramyil V. M, Misauno M. A., Ojo E.O., Ogwuche E. I., Sani A. A. Reasons for cancellations of urologic day care surgery. Nigerian of Surgical Research 2006; 8 (1 – 2): 30- 33.
10. El-Bushra A.D., Mohamed I.M., Awadalla M.A., Mohamed Y.B., Salah E.M. Cancelled elective surgical operations at El Obeid Hospital, Western Sudan. Sudan Med. J. 2008; 44 (1, 2 and 3):56-61
11. Are elective surgical operations cancelled due to increasing medical admissions? Robb WB, O’Sullivan MJ, Brannigan AE, Bouchier-Hayes DJ. Ir J Med Sci. 2004 JulSep;173(3):129-32.
12. Elective surgery--cancellations, ring fencing and efficiency. Aaserud M, Trommald M, Boynton J. Tidsskr Nor Laegeforen. 2001 Sep 10;121(21):2516-9.
13. Impact of emergency admissions on elective surgical workload. Nasr A, Reichardt K, Fitzgerald K, Arumugusamy M, Keeling P, Walsh TN. Ir J Med Sci. 2004 JulSep;173(3):133-5.
14. Chalya PL, Gilyoma JM, Mabula JB, Simbila S, Ngayomela IH, Chandika AB, Mahalu W. Incidence, causes and pattern of cancellation of Elective surgical operations in a University Teaching Hospital in the Lake Zone, Tanzania. African Health Sciences Vol 11 No 3 September2011: 438-43.
15. Jonnalagadda R, Walrond ER, Marinara S, et al. Evaluation of the reasons for cancellations and delays of surgical procedures in a developing country. Int Clin Pract. 2005;59:716–720.
16. Venkartaraman S, Seriam K. Cancelled elective surgery: study in an Indian Corporate Hospital. Indian Surg. 1997;59:372–376.