Cancellation Of Elective Surgery Research Articles

An Observational Study on the Loss of Economy Due to Surgery Cancellation in a Tertiary Care Hospital, Kashmir India and Suggestions for Improvement

The present study was conducted to identify and estimate cost borne by cancellation of elective surgeries in a tertiary care hospital in Kashmir India .The data of scheduled elective surgeries was collected. Inpatient medical records were reviewed for elective surgeries in 6 months starting from October 2023 to march 2024. During the course of study 3000 cases were scheduled to undergo impatient elective surgical procedures. Out of these 149 were cancelled. Among the cancelled cases 105 were cancelled during the preparation in the surgery wards and 44 were cancelled in operation room. The total cost of surgery cancellation was 58050 US$. Out of this 27804 US$. (48%) was related to bed expenses, 90685 US$. (17%) was related to physician visits and 203175 US$. (35%) for direct cost related resources and supplies

Cancellation and Resumption of Elective Surgeries Over Time Across a National Sample of US Hospitals During the COVID-19 Pandemic

Cancellation and Resumption of Elective Surgeries Over Time Across a National Sample of US Hospitals During the COVID-19 Pandemic

Equity in the recovery of elective and oncological surgery volumes after the COVID-19 lockdown: a multicentre cohort study in Italy

BackgroundThe COVID-19 pandemic has had, and still has, a profound impact on national health systems, altering trajectories of care and exacerbating existing inequalities in health. Postponement of surgeries and cancellation of elective surgical procedures have been reported worldwide. In Italy, the lock-down measures following the COVID-19 pandemic caused cancellations of surgical procedures and important backlogs; little is known about potential social inequalities in the recovery process that occurred during the post-lockdown period. This study aims at evaluating whether all population social strata benefited equally from the surgical volumes’ recovery in four large Italian regions.MethodsThis multicentre cohort study covers a population of approximately 11 million people. To assess if social inequalities exist in the recovery of eight indicators of elective and oncological surgery, we estimated Risk Ratios (RR) through Poisson models, comparing the incidence proportions of events recorded during COVID-19 (2020-21) with those in pre-pandemic years (2018-19) for each pandemic period and educational level.ResultsCompared to 2018-19, volumes of elective surgery showed a U-shape with the most significant drops during the second wave or the vaccination phase. The recovery was socially unequal. At the end of 2021, incidence proportions among highly educated people generally exceeded the expected ones; RRs were 1.31 (95%CI 1.21–1.42), 1.24 (95%CI 1.17–1.23), 1.17 (95%CI 1.08–1.26) for knee and hip replacement and prostatic surgery, respectively. Among low educated patients, RR remained always < 1. Oncological surgery indicators showed a similar social gradient. Whereas volumes were preserved among the highly educated, the low educated were still lagging behind at the end of 2021.ConclusionsSurgical procedures generally returned to pre-pandemic levels but the low educated experienced the slowest recovery. An equity-oriented appraisal of trends in healthcare provision should be included in pandemic preparedness plans, to ensure that social inequalities are promptly recognised and tackled.

Variability of the treated biomedical waste disposal behaviours during the COVID lockdowns.

Literature review suggests that studies on biomedical waste generation and disposal behaviors in North America are limited. Given the infectious nature of the materials, effective biomedical waste management is vital to the public health and safety of the residents. This study explicitly examines seasonal variations of treated biomedical waste (TBMW) disposal rates in the City of Regina, Canada, from 2013 to 2022. Immediately before the onset of COVID-19, the City exhibited a steady pattern of TBMW disposal rate at about 6.6kg∙capita-1∙year-1. However, the COVID-19 pandemic and its associated lockdowns brought about an abrupt and persistent decline in TBMW disposal rates. Inconsistent fluctuations in both magnitude and variability of the monthly TBMW load weights were also observed. The TBMW load weight became particularly variable in 2020, with an interquartile range 4 times higher than 2019. The average TBMW load weight was also the lowest (5.1 tonnes∙month-1∙truckload-1) in 2020, possibly due to an overall decline in non-COVID-19 medical emergencies, cancellation of elective surgeries, and availability of telehealth options to residents. In general, the TBMW disposal rates peaked during the summer and fall seasons. The day-to-day TBMW disposal contribution patterns between the pre-pandemic and post-pandemic are similar, with 97.5% of total TBMW being disposed of on fixed days. Results from this Canadian case study indicate that there were observable temporal changes in TBMW disposal behaviors during and after the COVID-19 lockdowns.

Prevalence and Causes of Elective Surgery Cancellations After Patients are Taken to the Operating Room: A Prospective, Cross-Sectional Study.

This study aimed to investigate the causes and prevalence of elective surgery cancellations in the operating room, and the clinical outcomes of affected patients. This prospective, cross-sectional study assessed the prevalence and causes of elective surgery cancellations once patients are in the operating room. A tertiary academic referral center hosted the study between January 2022 and January 2023. The study sample consisted of 7,482 adult patients scheduled for elective surgeries and taken to the operating room. The 7,415 completed procedures were in Group 2, whereas the 67 cancelled surgeries were in Group 1. Patients were divided into two groups on the basis of whether their surgeries were completed or cancelled. Factors such as age, American Society of Anesthesiologists (ASA) status, and surgical department were analyzed. The two groups were compared on the basis of age, ASA status, surgical department, and surgery time (month and day). Elective surgery cancellations occurred in the operating room at a rate of 0.9%. Group 1 was substantially older than Group 2 (p<0.001). Group 1 had a larger number of ASA III patients (p<0.001). The department with the highest cancellation rate was ophthalmology (2.5%), followed by general surgery (2.1%), urology (1.5%), and ear, nose, and throat (1.4%). It was possible to avoid 59.7% of cancelations. The study revealed a 0.9% prevalence rate of elective surgery cancelations in the operating room. Older age and higher ASA status greatly influenced these cancellations. Optimized surgery scheduling and patient assessment processes may prevent many of these cancellation.

The Incidence and Associated Factors of Patient Cancellation Scheduled for Elective Surgery From February to May at Debremarkos Comprehensive Spetialized Hospital, Debremarkos, Northwest Ethiopia, 2022 Gc. A Cross Sectional Study

Background: High rates of cancellation of surgical procedures are common in hospital settings, which may subsequently lead to economic loss to hospitals besides the burden given to patients, their families, and medical teams. It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload, and wastes operating room time. Cancellation of elective surgical procedures also causes significant emotional trauma to the patients as well as their families and the community in general, and its impact on hospital resources is great due to prolonged hospitalization and the high cost of health care [1]. This study aimed to assess the incidence and causes of patient cancellation scheduled for elective surgery in Debre Markos Comprehensive Specialized Hospital., Debremarkos, Northwest Ethiopia, 2022 GC. Methods and Materials: A prospective cross-sectional study was conducted on the cancellation of scheduled surgery at Debremarkos Comprehensive Specialized Hospital with a total of 282 sample size from February-01-May-13 consecutive months of 2022 G C. The data was collected from the operating room daily surgical schedule, preoperative anesthesia record sheet, primary physicians, and the anesthetist responsible for the preoperative assessment and conducting the case and by communicating patients if required. Analysis will be done by using SPSS (Version 20). Descriptive as well as analytic statistics are used for variables and data will be presented by tables, graphs, charts, and texts. Result: A total of 1055 patients were scheduled for elective Surgery in Debremarkos Comprehensive Specialized Hospital. During the study period 282(26.7%) of the patients had their surgery cancelled for various reasons in Debremarkos Comprehensive Specialized Hospital. The two most frequent reasons for cancellation were lack of bed (50.0%) and unfit for anesthesia (15.2%) in DMCSH.Conclusion and Recommendation: In conclusion, the cancellation rate of scheduled surgeries is high in general adult surgery at Debremarkos Comprehensive Specialized Hospital. The majority of causes are foreseeable and avoidable, and many are related to the hospital itself. We recommend that a facility for hospital preadmission be created.

The Incidence and Associated Factors of Patient Cancellation Scheduled for Elective Surgery From February to May at Debremarkos Comprehensive Spetialized Hospital, Debremarkos, Northwest Ethiopia, 2022 Gc. A Cross Sectional Study

Background: High rates of cancellation of surgical procedures are common in hospital settings, which may subsequently lead to economic loss to hospitals besides the burden given to patients, their families, and medical teams. It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload, and wastes operating room time. Cancellation of elective surgical procedures also causes significant emotional trauma to the patients as well as their families and the community in general, and its impact on hospital resources is great due to prolonged hospitalization and the high cost of health care [1]. This study aimed to assess the incidence and causes of patient cancellation scheduled for elective surgery in Debre Markos Comprehensive Specialized Hospital., Debremarkos, Northwest Ethiopia, 2022 GC. Methods and Materials: A prospective cross-sectional study was conducted on the cancellation of scheduled surgery at Debremarkos Comprehensive Specialized Hospital with a total of 282 sample size from February-01-May-13 consecutive months of 2022 G C. The data was collected from the operating room daily surgical schedule, preoperative anesthesia record sheet, primary physicians, and the anesthetist responsible for the preoperative assessment and conducting the case and by communicating patients if required. Analysis will be done by using SPSS (Version 20). Descriptive as well as analytic statistics are used for variables and data will be presented by tables, graphs, charts, and texts. Result: A total of 1055 patients were scheduled for elective Surgery in Debremarkos Comprehensive Specialized Hospital. During the study period 282(26.7%) of the patients had their surgery cancelled for various reasons in Debremarkos Comprehensive Specialized Hospital. The two most frequent reasons for cancellation were lack of bed (50.0%) and unfit for anesthesia (15.2%) in DMCSH. Conclusion and Recommendation: In conclusion, the cancellation rate of scheduled surgeries is high in general adult surgery at Debremarkos Comprehensive Specialized Hospital. The majority of causes are foreseeable and avoidable, and many are related to the hospital itself. We recommend that a facility for hospital preadmission be created.

Prioritization of Scheduled Surgeries Using Fuzzy Decision Support and Risk Assessment Methods

The aim of this study was to develop a method to minimize the risk of cancellation of planned surgery in hospital orthopedic departments. The paper proposes a method that combines multi-criteria and multi-faceted risk assessment. Two data sources are used: a fuzzy FTOPSIS method, combined with FMEA assessment. The FMEA method presented in this paper uses the technique of prioritizing preferences according to FTOPSIS similarity to the ideal solution and belief structure, in order to overcome the shortcomings of traditional FMEA indicators. Finally, a numerical case study of process optimization for elective surgery in a Polish clinic is presented. The focus was on planned hip replacements. The effectiveness of the method in assessing the main factors influencing cancellation of elective surgery is demonstrated. A high accuracy of the results and wide adaptability of the method to other areas are features of the combination of the abovementioned methods. The problem addressed in this publication is the high rate of cancellation of elective surgery. The selection of relevant criteria, their importance, and the preferences of the patients were studied. The results of the method provide a viable action plan for the proposed research problem. The proposed method is multifaceted and can be part of an information system to support reorganization, restructuring, and modification of an operational process.

Exploring the rate and reasons for same-day cancellation of cardiac surgery after implementing joint commission international standards: a retrospective cross-sectional study

BackgroundSame-day cancellation of cardiac surgery significantly impacts operating room management efficiency, which can be mitigated by taking preventive measures. This study aimed to explore the same-day cancellation rate of elective adult cardiac surgery, as well as the reasons for those cancellations. A retrospective cross-sectional study reviewed the records of 581 scheduled elective adult cardiac surgical cases at a single cardiac center from June 2017 to May 2018. The same-day cancellation reasons were grouped into four broad categories: nonclinical cancellations, clinical cancellations, patient-related cancellations, and 'other reason' cancellations. A case was considered canceled when it was not performed on the same day as the planned surgery.ResultsA total of 581 elective adult cardiac surgeries were scheduled during the study period, and 56 (9.63%) of these were canceled. The highest cancellation rate was due to nonclinical cancellations, with 39% of scheduled cases, followed by clinical cancellations, with a 34% cancellation rate. Patient-related cancellations accounted for 23% of cancellations, while the lowest rate was due to ‘other reasons,’ which accounted for 4% of total cancellations. The most common reason for nonclinical cancellations was the inclusion of emergency cases (n = 8; 14%). The most common reason for clinical cancellations was changes in the patient’s medical condition (n = 8, 14%). The common reason for patient-related cancellations was the refusal of surgery (n = 9; 16%). The lowest rate was for menstruating female patients (n = 2; 4%).ConclusionsThe same-day cancellation rate was 9.36%, and most of the cancellation reasons could be mitigated by implementing preventive strategies to improve the efficiency of the operating room. Preoperative preparation clinics and paying particular attention to female patients scheduled for surgery might reduce the rate of elective cardiac surgery cancellation.

Predictors of same day cancellation of elective surgery.

Same day cancellations of surgery have adverse effects on both patients and health care systems. To date, the majority of research has evaluated reasons for same day cancellation, and relatively little is known about risk factors for cancellation. The aim of this study is to develop and evaluate the accuracy of a model for preoperatively predicting which patients are at risk for experiencing same day cancellation. While accurately predicting which patients are likely to experience same day cancellation remains challenging, predictive models may aid in the early identification of patients at risk for cancellation. Future studies are required to assess whether the use of predictive analytics leads to reduced cancellation rates in practice.

Cancellation of Elective Oral and Maxillofacial Surgery, a Tertiary Hospital Experience.

Cancellation of elective surgery is said to occur when a patient's name appears on the operation list, but the operation is not done on the intended date. Cancelling elective surgeries is a long-standing problem faced by many countries worldwide. Reasons for cancellation of surgery vary from one hospital to another. The goal of this study was to identify factors associated with the cancellation of scheduled Oral and maxillofacial surgeries in the Lagos State University Teaching Hospital. Cancellations of elective scheduled operations from January 2021 to July 2022 were reviewed retrospectively. All cancellations were recorded in a predesigned form which included information about the age of the patient, hospital identification number, date of cancellation, type of operation, the Surgeon and the Anaesthetist, preoperative anaesthetic evaluations, any associated medical problems and the presumed reasons for cancellations for in-patients and day case surgery. Patients who died before the time of their scheduled surgery were excluded. 80 patients had their operation cancelled on the day of surgery, and the rate of cancellations was 44.2%. The most common causes of cancellations were patient-related (50%), accounting for up to half of the cancellations. The major reason for cancellation under the administrative category was insufficient time in the theatre to complete the operation list (18.8%). Financial constraint (16.3%) on the day of the surgery was noted more among planned day case procedures and delayed laboratory results (12.5%); oftentimes, covid test results were the major reasons for cancellations under the patient-factors category. The rate of cancellation in this study was high, most of which are patients related. Administrative-related reasons were also identified. However, in most cases, these cancellations can be avoided.

Elective surgery cancellations due to suboptimal medicine management: a retrospective single site study

AbstractBackgroundElective surgery cancellations and delays are associated with negative financial and staffing ramifications, adverse clinical outcomes, and poor patient outcomes. The Princess Alexandra Hospital in Brisbane, Australia, performs approximately 15 000 elective surgeries per year and medication optimisation is pivotal in preparing a patient for surgery to avoid same day of surgery theatre cancellations. Ideally, patients are seen in a multidisciplinary pre‐admission clinic for optimisation of their health and medicines, and to provide education regarding their surgery.AimTo calculate the incidence of elective surgery cancellations due to medication misadventure over a 12‐month period.MethodA retrospective audit at a tertiary Queensland Hospital was conducted over a 12‐month period (April 2021–March 2022), including patients who had their elective surgeries cancelled. The medical records from the hospital's digital databases for patients who were identified by the hospital coding service as ‘unfit for surgery’ were screened to see if the reason for the surgery cancellation was due to medication misadventure. The project was reviewed by the Metro South Human Research Ethics Committee and deemed exempt from further review (Ref No: CM20221651).ResultsThe surgery cancellation rate was 50% (n = 6626 cancelled surgeries from 13 255 total surgeries booked). The same day of surgery cancellation rate was 5.5% (n = 734). Medication misadventure resulting from suboptimal medicine management was responsible for 1% (n = 66 out of 6626 surgery cancellations). A total of 41% (n = 27) of patients had their surgery cancelled ahead of time by the pharmacist due to a medication not being withheld for long enough, which prevented a same‐day cancellation.ConclusionHaving a pre‐admission clinic pharmacist improves preoperative medication optimisation and has been proven to avoid same‐day cancellations.

How does trauma secondary to unexpected extreme weather affect orthopaedic surgery departments? An epidemiological study on the Filomena snowstorm.

Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, has been one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients made the Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events. Retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group). The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay to surgical treatment. A total of 1237 patients were included in total, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In Filomena, surgically treated fractures increased by 168%, being more severe, as C-type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78days during the snowstorm. Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures it is to be expected, which will imply elective surgery cancellation, damaging patients and increasing costs.

Elective surgery cancellations in pediatric surgery: rate and reasons

IntroductionCanceling pediatric elective surgery leads to multiple disturbances regarding the inefficient operating room (OR) management, the financial repercussions, and the psychological impact on the patient and his family. This study aims to identify the reasons for cancellations among the pediatric population in our setting and suggest some convenient solutions.MethodsWe carried out a prospective and descriptive study over 12 months in the pediatric surgery department of Fattouma Bourguiba University Hospital.ResultsOne thousand four hundred twenty-six patients were scheduled for surgery at the pediatric surgery department, of whom 131 (9.2%) were canceled. Medical and anesthesia-related reasons accounted for 62.5% of all cancellations, followed by surgical reasons at 16%, organizational or administrative issues at 11.5%, and patient-related reasons at 10%. The most significant causes were upper respiratory tract infections (URTIs) in 36.6%, abnormal blood test results in 16%, and non-adherence to preoperative fasting in 9.2%.ConclusionsThe rate of pediatric elective surgery cancellations at Fattouma Bourguiba University Hospital was higher than the accepted average rate (5%). Therefore, to prevent these cancellations as much as possible, efforts should be made to promote children’s medical care, operation scheduling, and efficient institution resource utilization.

The Association of Bedside Nurse Staffing on Patient Outcomes and Throughput in a Pediatric Cardiac Intensive Care Unit

AbstractHealth care throughput is the progression of patients from admission to discharge, limited by bed occupancy and hospital capacity. This study examines heart center throughput, cascading effects of limited beds, transfer delays, and nursing staffing on outcomes utilizing elective surgery cancellation during the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic wave. This study was a retrospective single-center study of staffing, adverse events, and transfers. The study period was January 1, 2018 to December 31, 2020 with the SARS-CoV-2 period March to May 2020. There were 2,589 patients, median age 5 months (6 days–4 years), 1,543 (60%) surgical and 1,046 (40%) medical. Mortality was 3.9% (n = 101), median stay 5 days (3–11 days), median 1:1 nurse staffing 40% (33–48%), median occupancy 54% (43–65%) for step-down unit, and 81% (74–85%) for cardiac intensive care unit. Every 10% increase in step-down unit occupancy had a 0.5-day increase in cardiac intensive care unit stay (p = 0.044), 2.1% increase in 2-day readmission (p = 0.023), and 2.6% mortality increase (p &lt; 0.001). Every 10% increase in cardiac intensive care unit occupancy had 3.4% increase in surgical delay (p = 0.016), 6.5% increase in transfer delay (p = 0.020), and a 15% increase in total reported adverse events (p &lt; 0.01). Elective surgery cancellation is associated with reduced high occupancy days (23–10%, p &lt; 0.001), increased 1:1 nursing (34–55%, p &lt; 0.001), decreased transfer delays (19–4%, p = 0.008), and decreased mortality (3.7–1.5%, p = 0.044). In conclusion, Elective surgery cancellation was associated with increased 1:1 nursing and decreased mortality. Increased cardiac step-down unit occupancy was associated with longer cardiac intensive care unit stay, increased transfer, and surgical delays.

Impact of pausing elective hip and knee replacement surgery during winter 2017 on subsequent service provision at a major NHS Trust: a descriptive observational study using interrupted time series

ObjectivesTo explore the impact of a temporary cancellation of elective surgery in winter 2017 on trends in primary hip and knee replacement at a major National Health Service (NHS) Trust,...

An audit to assess the number and reasons for on-the-day cancellations of elective oral and maxillofacial surgeries

The aim of this audit was to identify the magnitude of on-the-day elective surgery cancellations within the oral and maxillofacial department at East Kent Hospital University Foundation Trust, and then to be able to evaluate the reasons for them and suggest any necessary improvements to alleviate the situation.

Cancellation of elective surgery and associated factors among patients scheduled for elective surgeries in public hospitals in Harari regional state, Eastern Ethiopia.

Canceling elective surgeries is a significant problem in many hospitals leading to patient dissatisfaction, increased costs, and emotional trauma for patients and their families. Despite this, there is limited information about the cancellation of elective surgeries in Ethiopia, mainly in the study area. This study aimed to assess the magnitude of cancellation and associated factors among patients scheduled for elective surgeries in public hospitals in the Harari Regional State, Eastern Ethiopia, from 1 August to 30 August 2021. A hospital-based cross-sectional study was conducted on 378 patients scheduled for elective surgeries. Data were gathered using a non-random sequential sampling approach. In addition, a structured face-to-face interviewer-administered questionnaire was employed. The gathered information was input into Epidata version 3.1 and then exported to Statistical Package for Social Software version 26. To find the variables associated with the cancellation of elective surgeries, binary and multi-variable logistic regression analyses were conducted. In the binary analysis, all variables with a p-value of less than 0.25 were included in the multivariable analysis. Finally, a 0.05 p-value with a 95% confidence interval and an adjusted odds ratio was used to declare a significant association. This study included 378 patients scheduled for elective surgeries. Among those, 35.2% of the surgeries were canceled (95% confidence interval: 29.4-39.6). Being female (adjusted odds ratio: 2.46; 95% confidence interval: 1.44-4.203), lack of formal education (adjusted odds ratio: 2.03; 95% confidence interval: 1.15-3.58), place of residence (adjusted odds ratio: 1.70; 95% confidence interval: 1.03-2.81), increase in blood pressure (adjusted odds ratio: 5.09; 95% confidence interval:1.90-13.59), and ophthalmologic surgery (adjusted odds ratio: 3.76; 95% confidence interval: 1.41-10.0) were factors associated with the cancellation of elective surgeries. In this study, nearly one third of scheduled elective surgery was canceled. The primary contributing variables to the surgery cancellations were being female, lack of formal education, place of residence, ophthalmologic surgery, and increased blood pressure. Therefore, timely evidence-based reporting through the supervision team was advised to decrease cancellations.

Elective Surgery Cancellation in A Hospital Setting: A Review

Elective Surgery Cancellation in A Hospital Setting: A Review

Introducing a structured daily multidisciplinary board round to safely enhance surgical ward patient flow in the bed shortage era: a quality improvement research report

Hospital bed shortage is a worldwide concern. Their unavailability has caused elective surgery cancellations at our hospital peaking in spring 2016 at over 50%. This is often due to difficult...