A prospective parallel cohort study comparing a novel multi-priority emergency surgery waitlist management system to a paper-based system at a Canadian hospital

Abstract

BackgroundApproximately 20% of all surgery performed in Canada is scheduled by allocation into emergency operating room time. There is currently no national standard for managing how this mixture of emergent, urgent, and semi urgent surgical cases should progress to the operating room. MethodsWe introduced a novel dynamic multi priority emergency surgery waitlist management system to a medium-sized Canadian acute care hospital from December 1, 2018 to February 28, 2019. Our hospitals critical incident reporting system was monitored before and during the study for any evidence of related adverse patient safety events. Internet-based user acceptance surveys were collected from users at 28 days and 89 days into the study. Results703 operations were scheduled for 684 patients. The electronic system was reliable and had no outages or shutdowns over 89 days. There was no detectable change in the incidence of adverse patient safety events during the study. Overall, there were 54 system users enrolled in the study. The user acceptance survey results were not statistically significant but did show a preference for the new scheduling system in the surgeon user group, all other users preferred the original system. DiscussionWhile there are evident efficiencies from the use of information systems in other industries the safe introduction of a such a system in the emergency surgery setting has never been fully realized. The authors relate the development of the novel multi-priority emergency surgery waitlist management system that was introduced in this study. The challenges of implementing this system and the limitations of the study are discussed. ConclusionThe introduction of a novel emergency surgery waitlist management system into this active operating room setting for 89 days was not associated with a change in reported patient safety events. The tested system was reliable and was preferred by some surgeon users.