Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants_West China Medical Journal

Authors：

XU Lei ^1,2 , NIU Mingming ^1,2 , GAO Boxin ^1,2 , YU Deliang ^1,2 , YU Peihua ^1,2 ,  LIU Xiaonan ^1,2

1. Day Surgery Center, the First Affiliated Hospital of the Air Force Military Medical University, Xi’an, Shaanxi 710032, P. R. China;
2. Ambulatory Care Management Medical Quality Control Center of Shaanxi Province, Xi’an, Shaanxi 710032, P. R. China;

Corresponding author：

LIU Xiaonan, Email: 15353589999@163.com

Keywords：

Ambulatory surgery; doctor-patient assistant; surgical cancellation

DOI：

10.7507/1002-0179.202311286

Video：

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Objective To investigate the cancellation of ambulatory surgeries based on doctor-patient assistants, analyze the reasons, and propose corresponding strategies in order to improve the utilization of medical resources and the operational efficiency of hospitals. Methods A retrospective analysis was conducted on patient data between May 2021 and October 2023, who successfully scheduled surgery at the Day Surgery Center of the First Affiliated Hospital of the Air Force Military Medical University and cancelled the surgery due to various reasons. The reasons for the cancellation were also analyzed. Results A total of 5691 surgeries were scheduled, and 27 surgeries were cancelled before admission, with a cancellation rate of 0.47%. A total of 5607 surgeries were completed, and 57 surgeries were cancelled on the day of surgery, with a cancellation rate of 1.01%. Among all departments, patients in Gastrointestinal Surgery Department and Urology Department had the highest cancellation rates before admission (1.61% and 0.68%, respectively), and the highest cancellation rates on the day of surgery (1.43% and 1.38%, respectively). The most common reason for cancellation before admission was surgical doctor business travel/other arrangements (22.22%). The most common reason for cancellation on the day of surgery was preoperative respiratory infections in patients (14.04%). Conclusions The establishment of doctor-patient assistant positions can to some extent help reduce the cancellation of ambulatory surgery before admission and on the day of surgery. For patients undergoing ambulatory surgery, preoperative education and evaluation should be strengthened, and management processes and systems should be improved, in order to reduce the cancellation rate of ambulatory surgery and improve hospital operational efficiency.

Citation： XU Lei, NIU Mingming, GAO Boxin, YU Deliang, YU Peihua, LIU Xiaonan. Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants. West China Medical Journal, 2024, 39(2): 217-221. doi: 10.7507/1002-0179.202311286 Copy

1.	Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2.	嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
3.	于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
4.	徐蕾, 刘小南, 俞德梁, 等. 基于日间模式的手术患者当日出院的影响因素分析. 华西医学, 2022, 37(2): 194-198.
5.	陆晔峰, 林靖怡, 冯佳琪, 等. 日间手术护理管理的研究进展. 护理研究, 2018, 32(10): 1499-1503.
6.	杨思捷, 杨珂璐, 田小合, 等. 基于国际日间手术协会年会摘要热点主题的聚类分析和循证可视化研究. 中国实用外科杂志, 2022, 42(12): 1408-1415, 1427.
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8.	张沁青, 谭耘. 降低日间手术当日取消率的品管圈实践. 护理学报, 2020, 27(9): 19-22.
9.	杨陈, 张学兵, 敖伟, 等. 儿童日间手术当日手术取消的原因分析及对策. 护理学杂志, 2018, 33(6): 74-76.
10.	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.
11.	俞德梁, 刘小南, 高博欣, 等. 医患助理助力提升围手术期管理质量. 中国卫生质量管理, 2021, 28(5): 34-35, 43.
12.	俞德梁, 刘小南, 高博欣, 等. 计划性手术模式: 日间手术管理的新实践. 中国卫生质量管理, 2021, 28(7): 37-39, 47.
13.	刘茜, 黄明君, 马洪升, 等. 日间手术取消原因分析及对策. 华西医学, 2022, 37(9): 1352-1357.
14.	奚春花, 施东婧, 李芸慧, 等. 非白内障眼科日间手术当日取消率及原因分析. 中华医学杂志, 2022, 102(21): 1608-1613.
15.	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.
16.	Wong DJN, Harris SK, Moonesinghe SR, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK national health service hospitals. Br J Anaesth, 2018, 121(4): 730-738.
17.	孙辉, 明敏馨, 马旭东. 我国二、三级医疗机构日间手术发展现状分析. 中国医院管理, 2022, 42(3): 48-51.
18.	俞德梁, 刘小南. 日间手术发展展望. 医学与哲学, 2022, 43(22): 61-64.
19.	俞德梁, 刘小南. 我国日间手术政策文件的可视化分析. 中国卫生质量管理, 2022, 29(10): 31-34.
20.	顾静, 李婷. 个案管理师为主导的妇科日间手术护理流程的实施. 护理学杂志, 2019, 34(17): 21-24.
21.	杨艳英, 何梅, 陈熙, 等. 医生助理岗位应用于日间腹腔镜胆囊切除术的效果分析. 中国卫生质量管理, 2022, 29(10): 53-57.
22.	Abate SM, Chekole YA, Minaye SY, et al. Global prevalence and reasons for case cancellation on the intended day of surgery: a systematic review and meta-analysis. Int J Surg Open, 2020, 26: 55-63.
23.	程纯, 徐晓波, 杨柳, 等. 691 例住院患者择期手术取消原因分析和对策建议. 中国病案, 2017, 18(4): 35-39.
24.	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.

1. Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2. 嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
3. 于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
4. 徐蕾, 刘小南, 俞德梁, 等. 基于日间模式的手术患者当日出院的影响因素分析. 华西医学, 2022, 37(2): 194-198.
5. 陆晔峰, 林靖怡, 冯佳琪, 等. 日间手术护理管理的研究进展. 护理研究, 2018, 32(10): 1499-1503.
6. 杨思捷, 杨珂璐, 田小合, 等. 基于国际日间手术协会年会摘要热点主题的聚类分析和循证可视化研究. 中国实用外科杂志, 2022, 42(12): 1408-1415, 1427.
7. 焦雅辉. 中国日间手术发展报告(2020). 北京: 北京大学医学出版社, 2020: 1.
8. 张沁青, 谭耘. 降低日间手术当日取消率的品管圈实践. 护理学报, 2020, 27(9): 19-22.
9. 杨陈, 张学兵, 敖伟, 等. 儿童日间手术当日手术取消的原因分析及对策. 护理学杂志, 2018, 33(6): 74-76.
10. 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.
11. 俞德梁, 刘小南, 高博欣, 等. 医患助理助力提升围手术期管理质量. 中国卫生质量管理, 2021, 28(5): 34-35, 43.
12. 俞德梁, 刘小南, 高博欣, 等. 计划性手术模式: 日间手术管理的新实践. 中国卫生质量管理, 2021, 28(7): 37-39, 47.
13. 刘茜, 黄明君, 马洪升, 等. 日间手术取消原因分析及对策. 华西医学, 2022, 37(9): 1352-1357.
14. 奚春花, 施东婧, 李芸慧, 等. 非白内障眼科日间手术当日取消率及原因分析. 中华医学杂志, 2022, 102(21): 1608-1613.
15. 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.
16. Wong DJN, Harris SK, Moonesinghe SR, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK national health service hospitals. Br J Anaesth, 2018, 121(4): 730-738.
17. 孙辉, 明敏馨, 马旭东. 我国二、三级医疗机构日间手术发展现状分析. 中国医院管理, 2022, 42(3): 48-51.
18. 俞德梁, 刘小南. 日间手术发展展望. 医学与哲学, 2022, 43(22): 61-64.
19. 俞德梁, 刘小南. 我国日间手术政策文件的可视化分析. 中国卫生质量管理, 2022, 29(10): 31-34.
20. 顾静, 李婷. 个案管理师为主导的妇科日间手术护理流程的实施. 护理学杂志, 2019, 34(17): 21-24.
21. 杨艳英, 何梅, 陈熙, 等. 医生助理岗位应用于日间腹腔镜胆囊切除术的效果分析. 中国卫生质量管理, 2022, 29(10): 53-57.
22. Abate SM, Chekole YA, Minaye SY, et al. Global prevalence and reasons for case cancellation on the intended day of surgery: a systematic review and meta-analysis. Int J Surg Open, 2020, 26: 55-63.
23. 程纯, 徐晓波, 杨柳, 等. 691 例住院患者择期手术取消原因分析和对策建议. 中国病案, 2017, 18(4): 35-39.
24. 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.

West China Medical Journal

Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants

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