Obtaining day-of-surgery written surgical consent is associated with first-case delay

Area of Science:

• Anesthesiology
• Surgical Patient Care
• Healthcare Management

Background:

• Operating theatre (OT) start times are crucial for surgical efficiency.
• Preoperative processes, including informed consent, can impact surgical scheduling.
• Day-of-surgery patient arrivals from home present unique logistical challenges.

Purpose of the Study:

• To determine the association between the timing of surgical consent signature and first-start case delays.
• To identify factors contributing to operating theatre delays in same-day surgery patients.

Main Methods:

• A single-centre study analyzed consecutive first-start patients arriving from home over 28 days in June 2021.
• First-case delay was defined as operating theatre in-room time exceeding 5 minutes past the scheduled start.
• Statistical analysis, including odds ratios (OR) and confidence intervals (CI), was used to assess associations.

Main Results:

• Of 289 eligible patients, 81% signed surgical consent on the day of surgery in the preoperative area.
• Signing consent on surgery day increased the likelihood of OT delay by 3.2 times (OR 3.2, 95% CI: 1.2, 8.5, p=0.02).
• Patients with a non-English primary language faced a 3.8 times greater risk of case delay (OR 3.8, 95% CI: 2.0, 7.4, p<0.0001).

Conclusions:

• Same-day surgical consent signing for patients arriving from home is linked to significant operating theatre start time delays.
• Obtaining consent in the preoperative area should be minimized to enhance preoperative efficiency.
• Addressing consent timing and language barriers can improve surgical scheduling and patient flow.