Related Experiment Video
Updated: Mar 24, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Audit of emergent and urgent surgery for acutely ill pediatric patients: is access timely?
Grace Chan1, Sonia A Butterworth2
1Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Insights
Urgent surgeries in Canada often occur outside standard hours, with the most unstable patients experiencing the longest delays. This impacts patient outcomes and highlights a need for improved surgical scheduling.
Area of Science:
- Surgical Outcomes
- Healthcare Management
- Patient Safety
Background:
- Limited literature exists on urgent/emergent surgery wait times in Canada.
- Delays in non-emergent operations, particularly overnight, can elevate patient morbidity and mortality risks.
Purpose of the Study:
- To investigate patterns of surgical delays.
- To assess the performance of less-emergent surgeries conducted overnight.
Main Methods:
- Retrospective analysis of 4668 emergent/urgent surgeries from June 2011 to December 2013.
- Utilized the ORSOS database for patient and operative data.
- Classified surgeries into Class 1, 2A, 2B, and 3 with target times of 1, 6, 24, and 72 hours, respectively. Defined in-hours (IH) and out-of-hours (OOH) periods.
Main Results:
- Most urgent/emergent surgeries (73.2% Class 1, 71.5% Class 2A) were performed out-of-hours (OOH).
- Patients with the most severe conditions (Class 2B and 3) had the lowest rates of on-target performance (81.2% and 74.4% respectively).
- A significant increase in in-hours (IH) surgeries was observed, rising from 41.8% to 49.6%.
Conclusions:
- The majority of urgent and emergent surgeries are performed outside of standard operating hours.
- The most critically ill patients are least likely to undergo surgery within the targeted timeframe.
- Findings suggest potential inefficiencies in surgical scheduling and resource allocation for urgent cases.
Unlabelled:
There is a paucity of literature about wait times for urgent/emergent surgeries in Canada. Delays and performance of non-emergent operations overnight increase morbidity and mortality. The study aim was to determine patterns of delays and performance of less-emergent surgery overnight.
Methods:
A retrospective analysis (June 2011-December 2013) of emergent/urgent surgeries was conducted using the ORSOS database (prospective patient and operative data). Surgeries were classified: class 1, 2A, 2B, and 3: target times of 1, 6, 24 and 72h. In hours (IH)=7:45AM-3:30PM, M-F; others were out of hours (OOH) and overnight =2300-0700.
Results:
There were 4668 operations: class 1 (5.8%), 2A (29.1%), 2B (42.1%), and 3(23%). For class 1, 2A, 2B, and 3 surgeries, mean in-room times were 2, 4.7, 15.4, and 54h respectively; 59.2% (class 1), 81.9% (class 2A), 81.2% (class 2B) and 74.4%(class 3) were performed in target. OOH occurred for 73.2% (class 1), 71.5%(class 2A), 54.7% (class 2B), and 27.7% (class 3). There were 37 class 2B and 3 surgeries overnight. There was a significant increase surgeries IH: 41.8% to 49.6%.
Conclusion:
The majority of urgent/emergent surgery occurred OOH and the most unstable patients are least likely to have their operation within target.
Level Of Evidence:
4.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:17Assessment of apical pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...