Yoon S-Z, Lee S I, Lee H W, Lim H J, Yoon S M, Chang S H
Department of Anesthesiology and Pain Medicine, Korea University, Seoul, Korea.
Anaesth Intensive Care. 2009 Mar;37(2):261-6. doi: 10.1177/0310057X0903700203.
Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the number of cancellations that occurred before and after the installation of additional operating rooms. We surveyed all patients undergoing elective surgery for 100 days prior to and after the installation of additional operating rooms. The causes for cancellations were divided into six categories: departmental issues, abnormal laboratory results, patient denial, inadequate preparation, over-booking and other issues. The departmental causes were further divided into four categories: ward overflow, scheduling date errors, unavailable surgeons and other issues. The number of overall cancelled cases and scheduled cases increased following the increase in operating room capacity, although this increase was not statistically significant. However; the cancellation ratio rose significantly after the operating room capacity was increased. The primary reasons for cancellation prior to the increase in operating room capacity were departmental issues, over-booking and abnormal laboratory data, in that order. After the operating room capacity was increased, the primary reasons for cancellation were departmental issues, abnormal laboratory data and over-booking, in that order Taken together the results of this study indicate that increased operating room capacity can prevent cancellation due to over-booking. However; the numbers of cancellations due to ward overflow exceeded the numbers of cancellations that occurred as a result of over-booking. In conclusion, increasing the operating room capacity is not an appropriate option for preventing the cancellation of operations.
已经开展了多项研究，以评估手术室这一固定资源的利用情况，评估依据是那些可防止因手术能力不足而导致手术当天取消的条件。在本研究中，我们调查了择期手术取消的原因和总体发生率，然后比较了增设手术室前后发生的取消手术数量。我们对增设手术室前后100天内所有接受择期手术的患者进行了调查。取消手术的原因分为六类：科室问题、实验室结果异常、患者拒绝、准备不足、超额预订和其他问题。科室原因进一步分为四类：病房拥挤、排班日期错误、外科医生无法到位和其他问题。随着手术室容量的增加，取消手术的总病例数和预定手术病例数均有所增加，尽管这种增加在统计学上并不显著。然而，手术室容量增加后，取消率显著上升。手术室容量增加之前，取消手术的主要原因依次是科室问题、超额预订和实验室数据异常。手术室容量增加之后，取消手术的主要原因依次是科室问题、实验室数据异常和超额预订。综合来看，本研究结果表明，增加手术室容量可防止因超额预订导致的手术取消。然而，因病房拥挤导致的取消手术数量超过了因超额预订导致的取消手术数量。总之，增加手术室容量并非防止手术取消的合适选择。
