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[Surgical suspensions, a quality factor in pediatric surgical patient care]
R Ibarra Rodríguez1, R M Paredes Esteban1, F J Murcia Pascual1
1Unidad de Gestión Clínica de Cirugía Pediátrica. Hospital Universitario Reina Sofía. Córdoba.
Insights
Surgical suspensions (SQ) in pediatric surgery, primarily patient-related, were reduced by implementing efficiency measures. This led to significant cost savings and improved care, benefiting patients, professionals, and institutions.
Area of Science:
- Pediatric Surgery
- Healthcare Management
- Quality Improvement
Background:
- Surgical suspensions (SQ) represent a significant challenge in pediatric surgery services, impacting patient care and resource utilization.
- Identifying the root causes of SQ is crucial for developing effective interventions.
Purpose of the Study:
- To identify factors influencing surgical suspensions (SQ) in pediatric surgery.
- To estimate the economic impact of SQ.
- To analyze the effect of efficiency and care improvement strategies on SQ rates.
Main Methods:
- Retrospective analysis of SQ in 2015, categorizing causes (patient, organizational, professional).
- Comparative analysis of SQ rates in 2016 and 2017 after implementing corrective measures.
- Economic impact assessment based on lost operating hours.
Main Results:
- In 2015, the SQ rate was 8.9%, predominantly patient-related (90.7%).
- SQ were significantly more frequent in day surgery (10.84%) than inpatient surgery (2.63%).
- Post-intervention, SQ rates decreased significantly to 6.2% (2016) and 4.9% (2017), with associated costs reduced from €40,946 to €18,217.
Conclusions:
- Surgical suspensions pose challenges for patients, professionals, and institutions.
- Simple, feasible measures can effectively minimize SQ, enhancing efficiency and satisfaction.
- Interventions targeting the main causes of SQ yield significant improvements in pediatric surgical care.
Objective:
To identify the factors that influence surgical suspensions (SQ) in a pediatric surgery service, to estimate its economic impact and to analyze the effect that strategies aimed at increasing efficiency and improving medical-surgical care would have.
Materials And Methods:
Retrospective analysis of SQ in 2015, depending on the patient, organization or professionals, time of year, schedule (morning or afternoon) and type of surgery: major ambulatory surgery (CMA) or with hospital admission. Implementation of corrective measures against the main causes and subsequent comparative analysis in 2016 and 2017, comparing the results using Chi2 and Fisher's test. Evaluation of the economic impact based on lost operating hours.
Results:
The SQ rate in 2015 was 8.9%: 90.7% attributable to the patient, 6.8% to organizational factors and 2.7% to professionals. There were no significant differences according to the time of year or between morning or afternoon, but they were significantly more frequent in CMA (10.84% vs. 2.63%, p <0.001). After introducing improvement measures, SQ decreased significantly in 2016 and 2017 (6.2 and 4.9% respectively, p<0.01), mainly patient-dependent (80 and 73.9%, respectively, p=0.03). There were no differences between CMA and surgeries with admission and there was a decrease in the associated costs (€ 40,946 in 2015, € 18,217 in 2017).
Conclusions:
SQ represent an inconvenience for the patient, professionals and institution, that can be minimized with the implantation of simple, feasible and contrasted measures, that increase the efficiency and, probably, the satisfaction of users and professionals.
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