A retrospective study about cancellation of elective surgeries in a tertiary care hospital

Abstract

Introduction: Operation theaters (OTs) are one among the core functionalities in a health care institution that require a considerable amount of 5 Ms—man, machine, money, material, and management. Any idle time or underutilization in the OT creates a huge loss of these resources and is also inconvenient to patients and those on the waiting list. Thus, a planned and well-conceived operational method has to be followed to reduce the cancelations of scheduled cases and to optimally utilize the OTs so that they become more efficient. This study has been done to understand the basic reasons for the cancelation of elective surgeries at a tertiary care hospital and to effectively tackle them by suggesting suitable solutions to overcome these challenges. Objectives: Primarily, to understand the reasons for the cancelation of surgeries in OTs, and secondarily, to put forward suggestions for optimal usage of OTs. Materials and Methods: This was a retrospective study, with Pareto analysis and root cause analysis (RCA) as the tools. Records were obtained from the Central Scheduling Department of the Hospital between January 2020 and November 2022 (35 months). Results: During the study period, 53,177 surgeries were performed in the main OTs. There were 2289 (4.3%) cancelations. Nearly 84% of canceled surgeries were canceled within 24 h. Cancelations were 63% in males and 37% in females. Seventy-nine percent were of Indian nationality, and the rest were of various nationalities. Conclusion: The reasons for the cancelation of elective surgeries were multifactorial. Controlling these, and thus preventing cancelations, is imperative in the effective functioning of the institution as a whole. We recommend thorough evaluation, early preanesthetic checkup (PAC) and well-planned scheduling without haste as some of the measures to reduce the chances of cancelation.

Keywords

• cancelation; ot efficiency; reasons; resources; surgery