Reasons For Cancellation Research Articles

Proof of Coercion and Fraud in the Making of Notarial Deeds Case Study of South Jakarta District Court Decision Number 321/Pdt.G/2016/PN. Jkt. Cell

An agreement is one of the sources of engagement regulated in Chapter II of Book 3 of the Civil Code which can be stated in the form of a Notarial Deed. Authentic deeds clearly stipulate rights and obligations, providing legal certainty. In dispute resolution, authentic deeds function as the strongest written evidence. However, even with perfect evidentiary power, a Notarial Deed cannot be separated from efforts to cancel the contract. Some of the reasons for cancellation are due to defects in the agreement due to elements of coercion and/or elements of deception as stated by the Plaintiff in South Jakarta District Court Decision Number 321/Pdt.G/2016/PN. Jkt. Cell. Based on the research results, the Plaintiff is obliged to provide clear evidence. When compared with the Plaintiff's evidence, the evidence presented by the Plaintiff is not sufficient to prove the argument of coercion or fraud because the Plaintiff's Witnesses did not know that the Plaintiff and the Defendants had entered into a Sale and Purchase Agreement. In the process or attempt to cancel a notarial deed, the evidence must be clear and in such a way that the party who has the notarial deed does not need other evidence to state the truth of the notarial deed. With this formulation, the judge no longer needs to test its truth or in other words, an authentic deed has perfect evidentiary power both physically and materially.

Implementation of a Preanesthetic Telehealth Visit to Reduce Day-of-Surgery Cancellations

PurposeThe purpose of the telehealth preanesthesia clinic (PAC) is to reduce the number of day-of-surgery (DOS) cancellations through the implementation of an algorithm-based standardized protocol. DesignA prospective quality improvement project with pre and post assessment. MethodsOne hundred and fifty preoperative and postoperative surgical chart reviews using the Focus, Analyze, Develop, Execute, and Evaluate model. Retrospective chart reviews were conducted via the electronic health record to collect DOS cancellation counts along with reason for cancellation for a 6-week period prior to implementation, and a 6-week period postimplementation based on inclusion and exclusion criteria. FindingsThe implementation of a telehealth PAC using TEMPO (transition and action, evaluation and significant history, medications, procedure and condition, and overall plan) protocols resulted in a statistically significant reduction in DOS cancellations from 3.38% to 1.72%. ConclusionsPostimplementation findings support the use of a telehealth PAC to reduce DOS cancellations.

Abuse of Circumstances as a Reason for Cancellation of Agreement in the Indonesian Legal System

This research aims to find out the development of the doctrine of abuse of circumstances as a reason for canceling an agreement in the Indonesian Legal System. The proposed problem formulation contains: How is the development of the doctrine of abuse of circumstances in the Civil Law Legal System, especially Indonesia? and how is the consideration of judges in Indonesia in giving court decisions related to the doctrine of abuse of circumstances? This research includes normative legal research, with data collected based on written regulations and expert opinions. The results of this study indicate that the development of the doctrine of abuse of circumstances has been recognized in the Netherlands which adheres to the Civil Law System in the form of legislation, while Indonesia only recognizes this doctrine as limited to court decisions or has not been adapted in the form of legislation. Nevertheless, some judges in deciding civil cases in Indonesia recognize and use the doctrine of abuse of circumstances as a reason for canceling agreements in several civil cases. This shows a dilemma in the enforcement of justice in Indonesia, especially in the context of civil law considering that Indonesia adheres to the Civil Law System so that the main reference for judges in deciding cases is the law. In this case, the doctrine of abuse of circumstances has not been regulated in written civil law in Indonesia.

Neurosurgical Operative Cancellations in Canada: A Multicentre Retrospective Cohort Study.

Operative cancellations adversely affect patient health and impose resource strain on the healthcare system. Here, our objective was to describe neurosurgical cancellations at five Canadian academic institutions. The Canadian Neurosurgery Research Collaborative performed a retrospective cohort study capturing neurosurgical procedure cancellation data at five Canadian academic centres, during the period between January 1, 2014 and December 31, 2018. Demographics, procedure type, reason for cancellation, admission status and case acuity were collected. Cancellation rates were compared on the basis of demographic data, procedural data and between centres. Overall, 7,734 cancellations were captured across five sites. Mean age of the aggregate cohort was 57.1 ± 17.2 years. The overall procedure cancellation rate was 18.2%. The five-year neurosurgical operative cancellation rate differed between Centre 1 and 2 (Centre 1: 25.9%; Centre 2: 13.0%, p = 0.008). Female patients less frequently experienced procedural cancellation. Elective, outpatient and spine procedures were more often cancelled. Reasons for cancellation included surgeon-related factors (28.2%), cancellation for a higher acuity case (23.9%), patient condition (17.2%), other factors (17.0%), resource availability (7.0%), operating room running late (6.4%) and anaesthesia-related (0.3%). When clustered, the reason for cancellation was patient-related in 17.2%, staffing-related in 28.5% and operational or resource-related in 54.3% of cases. Neurosurgical operative cancellations were common and most often related to operational or resource-related factors. Elective, outpatient and spine procedures were more often cancelled. These findings highlight areas for optimizing efficiency and targeted quality improvement initiatives.

How to assess blepharoptosis via telemedicine: method and its reliability.

To report the method to assess belpahroptosis and its reliability of adult ptosis using video consultation. This is a retrospective, comparative, case series. The surgical waiting list for ptosis surgery between 8/2020 and 1/2021 was checked and only cases listed for surgery via video consultation assessment, without any previous face-to-face consultation, were included. The following data were collected for patients who underwent video consultation before surgery: Demographic data, level of experience of clinician, levator function, Cogan's twitch sign, fatigability test, eye motility, presence of lagophthalmos, clinical history to rule out Myasthenia Gravis, other myopathies or Horner syndrome, whether the surgery was performed or canceled, reason for cancellation, date of surgery, type of procedure and surgeon experience. A total of 176 patients underwent ptosis surgery. From those, 45 patients (25.6%) had only video assessment prior to surgery, 36 patients (80%) eventually underwent ptosis surgery. Surgery was canceled in 20% of the cases: in 2 cases (4.44%) due to misdiagnosis of ptosis during video consultation, confirmed on the day of surgery during pre-surgical face-to-face assessment; the other 7 cases (15.55%) belpharoptosis was confirmed on face-to-face examination but the surgery was canceled due to other reasons. The diagnosis of ptosis assessment via video consultation was corrected in 43 cases (95%) (p_value = 0.156, chi_ square). The accuracy of ptosis diagnosis was 13 out of15 (86.7%) by fellow assessments and 30 out of 30 (100%) by consultant assessments (p_value = 0.041, chi_ square). In most of the cases ptosis assessment in video consultation included: rough judgment of levator function, eye motility and checking signs of lagophthalmos. Video consultation is an efficient and reliable way to assess patients with ptosis, with 95% of reliability. Although a thorough ptosis assessment is advised, there was no difference between the accuracy of diagnosis on those who did not have the full suggested assessment.

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.

Cancellation of the more complicated ophthalmic inpatient surgeries in a tertiary general hospital: a 10-year retrospective study.

Although ophthalmic ambulatory surgeries are less costly and may enhance the more efficient utilization of hospital resources, inpatient surgeries were preferable alternatives for patients with complicated eye diseases or poor general health. However, the incidence, causes, and related factors of ophthalmic inpatient surgery cancellation remained largely unknown. The electronic medical records of ophthalmic inpatient surgeries between January 2012 and December 2022 was retrospectively reviewed. Cancellation-related factors were explored using multivariate logistic regression analysis and the reasons of cancellation were also evaluated. In total, 820 cancelled surgeries and 42,073 performed surgeries were included, with a cancellation rate of 1.9%. Any other ocular comorbidities were risk factors for cancellation (odds ratio (OR) 1.872, 95% confidence intervals (CI) 1.504-2.331; p < 0.001), while older age (OR 0.990, 95% CI 0.986-0.995; p < 0.001), local residence (OR 0.809, 95% CI 0.692-0.947; p = 0.008), any systemic comorbidities (OR 0.740, 95% CI 0.616-0.889; p = 0.001), and previous history of surgeries (OR 0.403, 95% CI 0.341-0.476; p < 0.001) were negatively associated with surgery cancellation. The top two categorical cancellation reasons were medical factors (508, 62.0%) and patient-related factors (285, 34.8%). "Patient/family refused surgery" (127, 15.5%), "acute conjunctivitis or uveitis relapse" (103, 12.6%), and "ocular condition improved and procedure no longer indicated" (71, 8.7%) were the three most common single cancellation reasons. Any other ocular comorbidities, younger age, no systemic comorbidities, non-local residence, and no past surgical history were related factors for ophthalmic inpatient surgery cancellation. The majority of cancellations were due to patient-related or medical factors. Great importance should be attached to the cancellation of the more complicated inpatient surgeries and further efforts are warranted to explore how to reduce cancellation.

Trends of Ophthalmic Surgery Cancellations at a County Hospital Before and During COVID-19: A 10-Year Retrospective Study

ABSTRACT Purpose Despite several publications on ophthalmic surgical cancellations discussing preventative causes in academic institutions, there remains a paucity of similar studies for safety-net hospitals. This study analyzed cancellation rates at a county hospital over a 10-year period. Methods This retrospective, open cohort study investigated a total of 11,350 surgeries scheduled at a tertiary-level county hospital between January 1, 2012 and December 31, 2021. Surgical cancellation reasons were collected from chart review and categorized into eight groups to allow for analyses. Cancellation rates were then calculated per year and per subspecialty. The primary statistical analyses were paired, 2-tailed t test and χ2 test. Results The most common reason for cancellation overall was institution-related (1065 surgeries), which was also the most common reason per year from 2012 to 2019 (range: 37.4% − 60.6%). In 2020, during COVID-19 stay-at-home mandates, the most common reason became COVID-related rescheduling, and in 2021, it was patient-driven. The cancellation rate in 2020 was significantly higher than 2019 (+9.27%,95% CI:4.96%-13.6%,p = .05), and significantly lower from 2021 to 2020 (−22.8%,95% CI:-26.8%-(-)18.7%,p = .001). Pediatric surgery had the highest cancellation rate overall (36.4%), but oculoplastics had the highest cancellation rate in 2020 (48.9%). Conclusion The most common reason for cancellation over the 10-year period was institution-related, in contrast to other publications based in academic centers. The study also had a higher cancellation rate than previously reported, again suggesting the difference between county and academic centers. The COVID-19 pandemic had a significant impact on cancellations, even after the COVID-19 stay-at-home orders were eased.

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.

Cancelled STEMI patients: what happen to them?

Abstract Introduction In the STEMI care network, the number of inappropriate cases sent to cathlab remains high 1. The use of technological innovations to share the diagnostic ECG tracing with the cardiology department has been shown to be effective in improving patient discrimination. Objective Our aim was to study the characteristics and prognosis (at discharge and 1-year follow-up) of patients whose transfer to the cathlab was cancelled. Material and Method Prospective study analysing all STEMI alert activations in 2022. Information on ECG pattern and clinical history was transmitted using an APP (ODiSEA 2-3) and used for cancellation. Patient characteristics, myocardial infarction, ECG activation pattern, angiography results, final diagnosis and clinical events during admission and 1-year follow-up were recorded. Patients who underwent urgent coronary angiography were excluded from the study. Results A total of 406 infarction codes were activated through the ODISEA APP. 122 (30%) of these were cancelled. The characteristics of the patients are shown in Table 1. Reasons for cancellation based on ECG pattern are shown in Figure 1.B. The most common were ST depression (23%) and intraventricular conduction disturbances (22.9%). The final diagnosis was ACS in 32.8% (STEMI 2.5%, NSTEMI 27% and unstable angina 3.3%). In the remaining 67.2%, the final diagnosis was atypical chest pain with negative biomarkers in 22.9%, arrhythmia in 17.2%, pericarditis in 9%, gastrointestinal pathology in 4.9%, heart failure in 4.9%, aortic dissection in 3.2%, PTE in 1.6% and other pathologies in 3.5%. (Figure 1.A). Coronary angiography was performed in 41 patients (33.6%). There were 36.6% with one vessel, 9.8% with two vessels and 22% with three vessels. Percutaneous revascularisation was required in 70% of patients. Discharge from the emergency department occurred in 46% of the patients. Hospital mortality occurred in 14 patients (11.4%). Of these, 3 (2.4%) were due to cardiac causes. Regarding events at 12 months, 6 (4.9%) were deaths (5 natural deaths and 1 due to cancer). 5 patients (4%) had ACS, 3 patients (2.4%) had stroke and 1 patient (0.8%) had digestive bleeding. Conclusions STEMI alert cancelled transfer patients are older, have more comorbidities and are less likely to have a final diagnosis of ACS or to have coronary lesions. They have a high rate of non-cardiovascular in-hospital mortality and a low rate of cardiovascular events at one year of follow-up.A.Final diagnosis. B. ECG patternTable 1.Patients characteristics

Patients cancelled after initial activation for suspected STEMI via the ODiSEA APP, what happens to them?

Abstract Introduction The use of technological innovation in STEMI care networks has been shown to be effective in sharing diagnostic ECG tracing and clinical information with the cardiology department, reducing the number of inappropriate cases transferred to the cathlab. These inappropriate cases have been shown to be more likely to die than those undergoing urgent coronary angiography, but data on incidence, cause of cancellation and prognosis are limited1. Objective Our aim was to investigate the characteristics and prognosis of patients in whom transfer to the cathlab was cancelled, compared with those who underwent emergent coronary angiography (EC). Material and Methods Prospective study analysing all STEMI alert activations during the year 2022. Information on ECG pattern and clinical history was transmitted using an APP (ODiSEA2,3). Based on the ECG pattern and clinical history, cancellations were made. Patient characteristics, myocardial infarction, ECG activation pattern, angiography results and in-hospital mortality were studied. Results A total of 406 infarction codes were activated through the ODISEA APP, of which 284 (70%) underwent EC and 122 (30%) were cancelled. The cancelled patients had a higher comorbidity than the transferred patients. The reasons for cancellation based on ECG patterns are shown in Figure 1. The most common were ST depression (23%), concave ST elevation (18.8%) and intraventricular conduction disturbances (22.9%). In addition, coronary angiography was performed in 33% of the cancelled patients compared to 99% of the transferred patients (p&amp;lt;0.001). The number of patients with coronary arteries without lesions was significantly higher in the cancelled group (31.7% vs. 9.6% p&amp;lt;0.001). In the EC group, 90.5% of patients presented with a final diagnosis of ACS, whereas in the cancelled group this was 32.8% (final diagnosis of STEMI 2.5% in the cancelled group vs. 83.5% in the CE group, p&amp;lt;0.001). Discharge from the emergency department was 46% in the cancellation group versus 2.7% in the transfer group (p&amp;lt;0.001). Finally, the in-hospital mortality rate was significantly higher in the cancelled group: 14 patients (11.4%) vs. 12 patients (4.2%) in the transferred group (p&amp;lt;0.001). Discussion Compared to patients who are transferred to a centre with cathlab, the subgroup of patients initially activated as STEMI alerts and eventually cancelled have a high comorbidity, a low probability of a final diagnosis of ACS and a high in-hospital.Table 1.Patients characteristicsFigure 1.ECG pattern

Incidence and root causes of surgery cancellations at an academic medical center in Iran: a retrospective cohort study on 29,978 elective surgical cases

IntroductionCanceling scheduled surgeries on the day of surgery places a heavy burden on healthcare providers and has psychological, social, and financial consequences on patients and their families. This study aimed to investigate the main reasons for cancellations of elective procedures and provide appropriate recommendations to reduce the rate of such avoidable cancellations.MethodsData were collected retrospectively from all consecutive elective cases scheduled for various elective surgeries from January 1, 2020 to March 31, 2022 at Namazi Teaching Hospital, a major referral center in southern Iran with a capacity of 938 beds. Daily data were collected on the number of planned electives, cancellations, and reasons for cancellations. Surgical cancellation reasons were categorized as patient-related, surgeon-related, hospital/system-related, and anesthesia-related. Data were expressed as frequency (percentage) and analyzed with SPSS version 19 software.ResultsThe cancellation rate on surgery day for elective procedures in all fields was 6.3%. The highest cancellation rate was related to minor surgeries (19%), followed by urology (8%), pediatrics (7%), and plastic surgery (7%). The most common reasons for cancellation were patients not suitable for the procedure (37%), followed by patients who did not follow instructions (10%), lack of time (10.5%), and equipment/supplies problems (10%), and refusal to consent (6%).ConclusionsAccording to this study, patients’ unsuitability for surgery, non-compliance with instructions, lack of time, and problems with equipment/supplies are the main reasons for canceling surgery. Proper preoperative assessment and preparation of patients and improved communication between medical teams and patients reduce the cancellation of booked surgeries.

귀화허가취소제도의 개선방안

The current revocation system of naturalization is not likely to initiate the revocation procedure because the basis clauses are incorrectly formed, the regulated acts cannot be clearly specified, and there is no reporting system in place. In addition, it is stipulated that the revocation procedure will be opened too late by allowing the Minister of Justice to initiate the cancellation procedure only after the conviction is finalized by forging or falsifying documents proving family relations. Overall, the current system of the revocation of naturalization permits is not sufficient to eliminate the illegal status obtained by foreign nationals abusing the naturalization system to pursue their own interests.&#x0D; In order to secure the effectiveness of the naturalization permission cancellation system, the types of acts stipulated in Article 21 of the Nationality Act and Article 27, Paragraph 1 of the Enforcement Decree of the Nationality Act must be integrated and reorganized. And “malignant abandonment of spouse” should be added as one reason for cancellation. Article 21, Paragraph 1 of the Nationality Act shall be amended as follows. The Minister of Justice may revoke the permission or judgment of a person who has been granted permission for naturalization, recovery of nationality, permission to renounce nationality, or judgment of holding nationality by making a false statement or forging or altering evidential documents for the purpose of obtaining permission for naturalization, etc. The same shall also apply to cases where a spouse is maliciously abandoned or a legal relationship that has resulted in the acquisition of nationality is falsely entered into.&#x0D; It is proposed to introduce a reporting system so that the naturalization permission revocation system can be operated effectively. The current revocation system does not have a notification system, so the possibility of the Minister of Justice initiating the revocation procedure is remarkably low. The fact that naturalization was granted illegally can only be known by those who have observed it over a long period of time. Therefore, Article 21-2 of the Nationality Act should be newly established as follows. ① Anyone who believes that a person has obtained permission for naturalization, etc. by making a false statement, oath, or forging or altering evidential documents may report the fact to the Ministry of Justice. ② When a public official believes that a person has obtained permission for naturalization by making a false statement or oath or forging or falsifying evidential documents in the course of performing his/her duties, he or she shall report the fact to the Ministry of Justice.

908 Factors Affecting Last Minute Cancellation of Elective General Surgical Cases; Preliminary Findings of a QIP

Abstract Introduction Waiting lists for elective general surgeries have been growing steadily over the past few years, with short-notice cancellations affecting both cost and patient safety. There are currently nationwide incentives to cut referral-to-theatre delays and tackle the backlog of over 7 million patients (NHS backlog data analysis - British Medical Association 2022). Aim To identify common causes of short-notice cancellation of elective general surgery lists, and identify targets for intervention for minimisation. Method This audit was registered with the department. Prospectively collected elective general surgery lists between January and November 2022 were compiled and analysed. We coded the reason for cancellation from patient records. For the patients found to be unfit on the day to come in (TCI), we reviewed PAC notes to see whether they had been deemed fit at PAC and how this had changed. Data were coded and analysed on Microsoft Excel on secure Trust computers. Results Between 01/01/2022 and 06/11/2022, 508 (22%) of the scheduled 2300 cases were cancelled, with 235 (10.2%) within 48 hours of their scheduled start date. Acute patient illness and patient unavailability were the most common causes of short notice cancellation of a case (n = 41), followed by time constraints (n = 33), patients not being medically optimised (n = 27) or no longer requiring surgery (n = 21, as well as administrative error (n = 14). Conclusions Targets for intervention following these preliminary audit results included improved patient literature at pre-assessment, clerical chart review in the lead up to the surgery to ensure all administrative tasks have been performed, and a clinical review immediately prior the TCI date to identify any intercurrent illness.

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.

The safety of telemedicine clinics as an alternative to in-person preoperative assessment for elective laparoscopic cholecystectomy in patients with benign gallbladder disease: a retrospective cohort study

BackgroundThe telemedicine clinic for follow up after minor surgical procedures in general surgery is now ubiquitously considered a standard of care. However, this method of consultation is not the mainstay for preoperative assessment and counselling of patients for common surgical procedures such as laparoscopic cholecystectomy. The aim of this study was to evaluate the safety of assessing and counselling patients in the telemedicine clinic without a physical encounter for laparoscopic cholecystectomy.MethodsWe conducted a retrospective analysis of patients who were booked for laparoscopic cholecystectomy for benign gallbladder disease via general surgery telemedicine clinics from March 2020 to November 2021. The primary outcome was the cancellation rate on the day of surgery. The secondary outcomes were complication and readmission rates, with Clavein-Dindo grade III or greater deemed clinically significant. We performed a subgroup analysis on the cases cancelled on the day of surgery in an attempt to identify key reasons for cancellation following virtual clinic assessment.ResultsWe identified 206 cases booked for laparoscopic cholecystectomy from telemedicine clinics. 7% of patients had a cancellation on the day of surgery. Only one such cancellation was deemed avoidable as it may have been prevented by a face-to-face assessment. Severe postoperative adverse events (equal to or greater than Clavien-Dindo grade III) were observed in 1% of patients, and required re-intervention. 30-day readmission rate was 11%.ConclusionsOur series showed that it is safe and feasible to assess and counsel patients for laparoscopic cholecystectomy remotely with a minimal cancellation rate on the day of operation. Further work is needed to understand the effect of remote consultations on patient satisfaction, its environmental impact, and possible benefits to healthcare economics to support its routine use in general surgery.

The impact of a preanesthesia assessment clinic on scheduled elective case cancelations at a Thai university hospital.

Elective surgical case cancelations negatively impact healthcare systems and patient dissatisfaction. Preanesthesia assessment clinics (PACs) have been established in many countries to facilitate preoperative medical optimization. However, their benefits for elective procedure cancelations in Thailand have not been formally assessed. This study evaluated the impact of a PAC on scheduled elective surgical case cancelations at a Thai university hospital. A retrospective cross-sectional study was conducted for the period covering from May 2016 to April 2017. We included all scheduled elective surgical cases at Siriraj Hospital, Thailand, canceled on the day of surgery. The cancelation incidences of patients attending and not attending the PAC were compared. Cancellation reasons were categorized as "patient issue," "hospital-facility issue," "surgeon issue," "anesthesiologist issue," "medical condition," and "miscellaneous." The PAC patients' reasons were rigorously explored to determine their preventability. There were 30,351 scheduled elective procedures during the study period. The case-cancelation incidences were 0.9% (95% confidence interval [CI], 0.7-1.2%) for patients visiting the PAC and 5.9% (95% CI, 5.6-6.3%) for those who did not. Medical conditions were the most common reason for cancelation for non-PAC patients (27.3%), whereas hospital-facility issues were the most frequent for PAC patients (43.8%). The cancelation rate for patient issues was significantly lower in the PAC group (4.2% vs 20.7%; P < .05). Thirty-one (64.6%) of the PAC patients' cancelations were potentially preventable. Of the 15 PAC patient cancelations related to medical conditions, 12 were for patients with a history of acute illness and were determined to be nonpreventable. Visiting the PAC was significantly associated with a decreased elective-case cancelation rate. Cancellations were most frequently related to hospital-facility issues for patients visiting the PAC and medical conditions for those who did not. Some PAC patient cancelations for medical conditions involved unpreventable acute patient illnesses. Clinical Trials.gov (NCT02816281).

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.

Bad Faith as a Reason for Cancellation of Trademarks Registered More Than Five Years According to Law Number 20 of 2016

According to Article 77 paragraph (2) of Law Number 20 of 2016 concerning Trademarks and Geographical Indications (UU MIG), a trademark cancellation lawsuit must be filed within five years from the date of trademark registration. Recently, a notable case involving the Cheong Kwan Jang trademark saw conflicting decisions from the Central Jakarta Commercial Court and the Supreme Court. Initially, the Central Jakarta Commercial Court rejected the application for cancellation of the Cheong Kwan Jang trademark filed by Korean Ginseng Corp. The court's reasoning was based on the inability of Korean Ginseng Corp. However, the Supreme Court, in its Decision Number 345 K/Pdt.Sus-HKI/2021, took a different stance and granted the request for cancellation of the mark that had been registered by PT. Mitra Sentosa International for more than five years. The basis for this decision was that the registration of the mark was deemed to have been done in bad faith, as outlined in Article 20 paragraph (3) of the MIG Law. Therefore, according to Article 77 paragraph (2) of the MIG Law, the brand could be canceled indefinitely, even though the five-year limit had passed. This study employs normative legal research, analyzing secondary data such as the Commercial Court Decision Number 15/Pdt.Sus/Merek/2020/PN.Niaga.Jkt.Pst and Supreme Court Decision Number 345 K/Pdt.Sus-HKI/2021, alongside relevant laws and regulations. The aim is to understand the reasons for the Commercial Court's rejection and whether the Supreme Court's decision aligns with the provisions of Article 77 of Law No. 20 of 2016.