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Analysis of 43 Intraoperative Cardiac Surgery Case Cancellations
Michael G Fitzsimons1, Joshua D Dilley1, Chris Moser2
1Massachusetts General Hospital, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Insights
Late surgical cancellations, often due to patient health changes, cause distress and waste operating room time. Understanding these causes can help reduce future cancellations.
Area of Science:
- Cardiovascular Surgery
- Healthcare Management
Background:
- Late surgical cancellations cause patient distress and resource waste.
- Operating room (OR) time and personnel are significantly impacted by cancellations.
Purpose of the Study:
- To identify causes of late cardiac surgical cancellations.
- To determine the preventability, OR time, and postoperative outcomes of cancelled cases.
Main Methods:
- Retrospective review of 43 cardiac surgical cases cancelled after patient entry into the OR.
- Data collected from January 1, 2010, to December 31, 2013, at Massachusetts General Hospital.
Main Results:
- Patient health status changes were the primary reason for cancellation (44%).
- Central catheter issues (18.6%) and organ availability (12%) were other significant factors.
- Total OR time lost for cancelled cases was 5,374 minutes.
Conclusions:
- Identifying cancellation causes is crucial for improving surgical scheduling.
- This data can inform strategies to minimize future surgical cancellations and optimize resource allocation.
Objective:
Late cancellation of surgery cases imposes significant emotional distress on the patient and their family and results in wasted resources, including loss of operating room and personnel time. This study was designed to determine the causes of cancellation, preventability, total operating room time, and postoperative destination.
Design:
This study was a retrospective review of the 43 cardiac surgical cases that were cancelled while the patient was in the operating room (OR) but prior to surgical incision.
Setting:
The cases were performed at the Massachusetts General Hospital, a teaching hospital of Harvard Medical School.
Participants:
Forty-three out of 5,110 scheduled cardiac cases were identified that were cancelled after the patient had entered the operating room between January 1, 2010 and December 31, 2013.
Interventions:
No interventions were made. This was a retrospective study.
Measurements And Main Results:
The most common causes of cancellation included a change in the patient's health status (44%), problems associated with central catheter placement (18.6%), and unsatisfactory donor organs for planned transplantation (12%). The majority were inpatients (65%) prior to the procedure. The cumulative OR time for all cancelled cases was 5,374 minutes (89 hours and 34 minutes).
Conclusions:
The reason for cancellation, preventability, total operating room time, and postoperative destination were determined. The information can be utilized to decrease the number of future cancellations.
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