Department of Management, Otago Business School, and Centre for Health Systems and Technology, University of Otago, 60 Clyde Street, Dunedin PO Box 56, Dunedin 9054, New Zealand.
Department of Management, Otago Business School, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
Int J Qual Health Care. 2021 Jun 26;33(2). doi: 10.1093/intqhc/mzab092.
Elective surgery cancellation is considered a fundamental problem in health care services-it causes considerable disruption to patient flow, further eroding often already stretched operating capacity, and consequentially reduces both hospital performance and patient satisfaction. This research presents a systematic review (SR) of the reasons for surgery cancellation among different hospitals and countries. By highlighting these causes, we identify how to reduce cancellations, thereby improving the use of surgical capacity and resources and creating a more predicable patient flow.
An SR was performed on elective surgery cancellation in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis and by assessing the methodological quality of SR with Measurement Tool to Assess Systematic Reviews guidelines.
There are different reasons for surgery cancellation that vary between hospitals. This SR demonstrates that hospital-related causes (e.g. unavailable operation room time, inappropriate scheduling policy and lack of beds) are the primary reason for surgery cancellation, followed by work-up related causes (e.g. medically unfit and changes in the treatment plan) and patient-related causes (e.g. absence of a patient and patient refusal).
This review demonstrates that the main causes for surgery cancellation can be controlled by hospital managers, who can aim to improve areas such as patient flow and capacity management. Ultimately, this will improve the quality of healthcare delivered by hospitals.
择期手术取消被认为是医疗服务中的一个基本问题——它会严重扰乱患者流程，进一步蚕食本已紧张的手术能力，从而降低医院绩效和患者满意度。本研究对不同国家和医院择期手术取消的原因进行了系统评价（SR）。通过强调这些原因，我们确定了如何减少取消手术的方法，从而提高手术能力和资源的利用效率，并创造更可预测的患者流量。
本 SR 符合系统评价和荟萃分析的首选报告项目，并使用评估系统评价的测量工具（Measurement Tool to Assess Systematic Reviews）评估了 SR 的方法学质量。
手术取消的原因因医院而异。本 SR 表明，医院相关原因（例如，手术室时间不可用、排程政策不当和床位不足）是手术取消的主要原因，其次是检查相关原因（例如，不适合手术和治疗计划变更）和患者相关原因（例如，患者缺席和拒绝手术）。
本综述表明，医院管理者可以控制手术取消的主要原因，他们可以努力改善患者流量和容量管理等方面。最终，这将提高医院提供的医疗保健质量。
