Causes for and countermeasures against day surgery cancellations_West China Medical Journal

Authors：

LIU Qian ¹ , HUANG Mingjun ^1,2 , MA Hongsheng ¹ , MU Min ^1,2 ,  DAI Yan ^1,2

1. Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Day Surgery Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DAI Yan, Email: dai1175@163.com

Keywords：

Day surgery; surgery cancellation; cause analysis; improvement measures

DOI：

10.7507/1002-0179.202112126

Video：

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Objective To analyze the causes for day surgery cancellations before admission or on the same day of operation, and put forward targeted measures to improve the medical resource utilization and patient satisfaction. Methods The basic information and clinical data of patients who had been scheduled for surgery in the Day Surgery Center of West China Hospital, Sichuan University between January 2018 and September 2021 were collected. The reasons for the surgery cancellations before admission or on the same day of operation were analyzed. Results From January 2018 to September 2021, a total of 45176 patients were successfully scheduled for day surgery, and 44300 patients completed surgery as planned. A total of 876 operations (1.94%) were cancelled after being scheduled, including 546 (1.21%) before admission and 330 (0.73%) on the surgery day. Ranked from high to low according to the cancellation rates, the top five departments were Department of Dermatology, Department of Vascular Surgery, Department of Hepatobiliary Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, and Department of Gastroenterology, with a cancellation rate of 3.38% (8/237), 2.90% (25/863), 2.85% (101/3548), 2.48% (171/6893), and 1.91% (260/13578), respectively. In the reasons for cancellations, patient factors accounted for 57.31% (502/876) and medical management factors accounted for 42.69% (374/876). Conclusions The cancellations of day surgery mainly occur before admission, and are mainly caused by patient factors. It is necessary to strengthen the preoperative education for day surgery patients, and enhance the communication and cooperation between surgery physicians, nurses and technicians, in order to reduce the operation cancellation rate and make reasonable and efficient use of medical resources.

Citation： LIU Qian, HUANG Mingjun, MA Hongsheng, MU Min, DAI Yan. Causes for and countermeasures against day surgery cancellations. West China Medical Journal, 2022, 37(9): 1352-1357. doi: 10.7507/1002-0179.202112126 Copy

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13.	Xu L, Ma Y, Wang S, et al. Incidence of gastrointestinal stromal tumor in Chinese urban population: a national population-based study. Cancer Med, 2021, 10(2): 737-744.
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15.	柳小卉, 柳存勖, 刘亚萍, 等. 日间手术当日取消的原因分析及对策. 东南国防医药, 2021, 23(3): 320-323.
16.	陆京伯, 蒲佐. 日间手术在治疗下肢静脉曲张中的应用. 血管与腔内血管外科杂志, 2020, 6(2): 112-115.
17.	李诗涵, 刘芳, 杜姣姣, 等. 日间手术患者当日取消手术原因分析及改进建议. 中国卫生质量管理, 2019, 26(4): 45-47.
18.	陶玉琼, 赵少华, 崔纪林. FOCUS-PDCA 程序在分散式日间手术模式围术期护理中的应用. 武警后勤学院学报(医学版), 2021, 30(2): 29-33.
19.	孔庆健, 朱新伟, 周璞, 等. 日间手术中心管理模式的实践. 中国卫生质量管理, 2009, 16(1): 26-29.
20.	徐洁. 独立日间手术中心的中国前路. 中国医院院长, 2018(18): 60-61.
21.	雷甜甜, 宋应寒, 吕修和, 等. 集中管理模式下的消化道息肉日间手术管理实践. 中华医院管理杂志, 2020, 36(2): 136-139.

1. 戴燕, 黄明君. 日间手术护理管理的实践. 中国护理管理, 2021, 21(6): 951-956.
2. Lionel R, Karim KM, Martin N, et al. Laparoscopic sleeve gastrectomy as day case surgery: a review of the literature. Surg Obes Relat Dis, 2019, 15(7): 1211-1217.
3. 李灿萍, 黄寿奖, 王东披, 等. 小儿日间手术标准化管理实践与探索. 中华医院管理杂志, 2019, 35(3): 209-212.
4. Williams OM, Faboya OM, Omisanjo OA. Parental post-operative telephone follow-up after paediatric day case surgery. World J Surg, 2021, 45(10): 3222-3229.
5. 张雨晨, 戴燕, 宋应寒. 日间手术护理质量敏感指标体系的构建. 华西医学, 2021, 36(2): 220-224.
6. 何琼, 张静, 周维强, 等. 湖南省某院日间手术实施现状分析. 中国病案, 2017, 18(2): 56-59.
7. 刘常清, 任宏飞, 李继平, 等. 日间手术管理模式与发展现状. 护理研究, 2016, 30(10A): 3466-3469.
8. 傅文静, 李晓玲. 日间手术临时取消的现状及其干预的研究进展. 广西医学, 2020, 42(18): 2429-2432, 2462.
9. 蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205.
10. Lee CM, Rodgers C, Oh AK, et al. Reducing surgery cancellations at a pediatric ambulatory surgery center. AORN J, 2017, 105(4): 384-391.
11. Hariharan S, Chen D, Merritt-Charles L. Evaluation of the utilization of the preanaesthetic clinics in a university teaching hospital. BMC Health Serv Res, 2006, 23(6): 59.
12. 王萍, 陈程. 日间手术护患流程化沟通模式应用. 解放军医院管理杂志, 2021, 28(1): 82-85.
13. Xu L, Ma Y, Wang S, et al. Incidence of gastrointestinal stromal tumor in Chinese urban population: a national population-based study. Cancer Med, 2021, 10(2): 737-744.
14. Guo CG, Cheung KS, Zhang F, et al. Incidences, temporal trends and risks of hospitalisation for gastrointestinal bleeding in new or chronic low-dose aspirin users after treatment for Helicobacter pylori: a territory-wide cohort study. Gut, 2020, 69(3): 445-452.
15. 柳小卉, 柳存勖, 刘亚萍, 等. 日间手术当日取消的原因分析及对策. 东南国防医药, 2021, 23(3): 320-323.
16. 陆京伯, 蒲佐. 日间手术在治疗下肢静脉曲张中的应用. 血管与腔内血管外科杂志, 2020, 6(2): 112-115.
17. 李诗涵, 刘芳, 杜姣姣, 等. 日间手术患者当日取消手术原因分析及改进建议. 中国卫生质量管理, 2019, 26(4): 45-47.
18. 陶玉琼, 赵少华, 崔纪林. FOCUS-PDCA 程序在分散式日间手术模式围术期护理中的应用. 武警后勤学院学报(医学版), 2021, 30(2): 29-33.
19. 孔庆健, 朱新伟, 周璞, 等. 日间手术中心管理模式的实践. 中国卫生质量管理, 2009, 16(1): 26-29.
20. 徐洁. 独立日间手术中心的中国前路. 中国医院院长, 2018(18): 60-61.
21. 雷甜甜, 宋应寒, 吕修和, 等. 集中管理模式下的消化道息肉日间手术管理实践. 中华医院管理杂志, 2020, 36(2): 136-139.

West China Medical Journal

Causes for and countermeasures against day surgery cancellations

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