ObjectiveTo provide reference for major hospital operating room management in China by summarizing the main results from articles involving cancellation of elective operations. MethodsWe systematically searched PubMed, China National Knowledge Infrastructure, VIP and Wanfang databases up to January 31, 2016. The main results of eligible articles were described. ResultsA total of 37 articles were included, one of which was not included for further qualitative analysis due to low quality. The research type of included studies were retrospective studies and prospective studies accounting for 62.16% and 27.03%, respectively. The research object and rate of cancelled operation were varied among studies (0.15%-40.80%). The causes of cancellation were divided into hospital-related factors, staff-related factors and patient-related factors. ConclusionsThe cancellation of elective surgery is an important influence factor for the quality of healthcare. Identifying avoidable areas and proposing relative suggestions are aimed to decrease the rate of cancellation.
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%). ConclusionsThe 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.
Objective To explore strategies to reduce the same-day cancellation rate of gynecological day surgery. Methods The same-day cancellation status of gynecological surgery in the Department of Day Surgery, West China Second University Hospital, Sichuan University from January to December 2021 (before improvement) was investigated. The causes of cancellation were analyzed from three aspects: patient-related factors, medical factors, and examination factors. Subsequently, management countermeasures were formulated for the controllable factors and continuous quality improvement was implemented. After improvement, the same-day cancellation rate of gynecological day surgery from September 2022 to January 2023 was collected and compared with that before improvement. Results Continuous quality improvement was implemented targeting three factors in day surgery, namely the short interval between patient’s visit time and pre-scheduled time, the irrational sequence of preoperative examinations for patients, and the non-standardized treatment of patients with abnormal vaginal discharge by physicians. The same-day cancellation rates of gynecological day surgery before and after the continuous quality improvement were 3.70% (156/4211) and 2.13% (30/1411), respectively, and the difference was statistically significant (χ2=8.231, P=0.004). ConclusionOptimizing the preoperative examination and admission process, effective preoperative education and physician-patient communication, establishing unified standards for the approval of vaginal discharge tests and standardized treatment protocols, and clarifying the responsibilities of the preoperative comprehensive assessment outpatient clinic along with the supervision system are effective measures to reduce the same-day cancellation rate of gynecological day surgery.