Preoperative Waiting Time Research Articles

Factors determining length of stay of surgical day-case patients.

Factors which lead to prolonged stay in the day-care unit and unplanned admission after day-case surgery are poorly understood. Data sets of 3152 day-case patients were collected with a computerized online record keeping system (NarkoData). Predictors of prolonged postoperative stay including unanticipated admission were identified using univariate analysis. Charts of patients, who needed admission, were reviewed. 13.2% of day-case patients had a postoperative stay < or = 3 h, 55.3% 3-6 h and 26.2% > or = 6 h. The rate of unanticipated admission was 5.4%. Intraoperative haemoglobin concentration and blood loss were the best predictors of a prolonged postoperative stay. Other significant predictors were female gender, advanced age, longer duration of surgery, larger volume of infusions, intubation, spinal anaesthesia, intraoperative use of opioids and non-depolarizing muscle relaxants, high pain score, nausea and vomiting and prolonged preoperative waiting time. Chart review of patients admitted to hospital confirmed the validity of the statistically significant predictors. In day-case surgery, the predictors of prolonged stay in the day-care unit and unplanned Hospital admission are mainly related to the surgical procedure.

Waiting for Satisfaction

This case study documents McKay-Dee Hospital Center's search for a solution for low patient satisfaction scores concerning wait times for surgery patients entering McKay-Dee's Same Day Department. Unable to expand to an appropriate size for present patient flow, the operating room/recovery room committee reviewed data on patient wait times at a physician level to determine an alternate solution to expansion. Data were gathered and refined, definitions were interpreted, and various steps in the scheduling processes were delineated, clarifying several issues that affected patient wait times. By studying the data in a committee setting rather than focusing on the human aspect, detrimental patterns such as late schedule changes and "catch-all procedures" were identified and logical solutions were suggested. In this manner, preoperative wait time targets were appropriately set, surgeons and staff were counseled, and surgical scheduling became more accurate. The result was a dramatic rise in patient satisfaction scores concerning preoperative wait times.