OR Fact and Principle

Abstract

Q. Can operative procedures be classified as “major” or ‘‘minor’’ with any degree of accuracy? A. The opinions of various surgeons, nurses and record librarians have been sampled regarding the classification of surgical cases into major and minor categories. Some surgeons think a surgery should be classified major if a cavity has been entered no matter what dimension. Many in the health field feel there is no such thing as a minor operation, for any surgery is of major importance to the patient. The two terms, “major surgery” and minor surgery” are so firmly established in our records that it seems unrealistic to attempt to abolish these terms completely. OR charges in the past were based almost entirely on “major”’ or “minor,” and slowly we are finding administrators changing to a flat charge, the amount varying as to time, classification, and the number of personnel needed for the procedure. However, we do seem to be slowly accepting other ideas for surgical classifications and perhaps the computer will find a more satisfactory substitution for us to settle the question nationally. In an article in the Journal of American Medical Association-Vol. 191, JanuaryMarch 1965, a scale is suggested for use in cases which present difficulty in classification, ( 6 a: