4.5 Article

An In-Depth Analysis of Providers and Services of Cancellation in Anesthesia Reveals a Complex Picture after Systemic Analysis

Journal

HEALTHCARE
Volume 11, Issue 3, Pages -

Publisher

MDPI
DOI: 10.3390/healthcare11030357

Keywords

peri-operative care; workflow; hospital; holidays; cancellation; precision medicine; efficiency; safety; operating room; surgery

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The variances in operating room cancellation rates between different service lines and operators within these service lines were assessed by reviewing the electronic medical record covering 34,561 cases performed by 199 OR operators in 2018. The study found that the cancellation rates differed between service lines but were minimal between operators within the same service line. The main factors contributing to cancellation variability were patient-specific factors, seasonal factors, and administrative issues.
The variances in operating room (OR) cancellation rates between different service lines and operators within these service lines were assessed by reviewing the electronic medical record (EMR) covering 34,561 cases performed by 199 OR operators in 2018. We assumed that cancellations would differ between different service lines, but the between-operators variance was minimal within the service line. We hypothesized that most variability would be secondary to patient-specific (weekdays, time of year, and national holidays), seasonal and administrative issues. Of 4165 case cancellations, the majority (73.1%) occurred before the patient arrived at the hospital. A total of 60% of all cancellations were within gastroenterology, interventional cardiology, and orthopedics. Cancellation rate variability between surgeons operating within the same service line greatly varied between services from very homogenous to very diverse across providers. The top reasons for cancellation were: date change, canceled by a patient, or no show. The highest cancellation rates occurred on Mondays and Tuesdays, in January and September, and during weeks associated with national holidays. In summary, cancellation variability must be analyzed at the level of individual specialties, operators, and time variability.

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