Implementation of evidence-based recommendations to reduce elective surgical case cancellations

Implementación de recomendaciones basadas en evidencia para reducir las cancelaciones de casos quirúrgicos electivos
Viderman D. Sarria-Santamera A. Umbetzhanov Y. Ismailova A. Ben-David B.
1 March 2021 Elsevier Espana S.L.U

Journal of Healthcare Quality Research
2021 #36 Issue 2 59 - 65 pp.

Background: Cancellation of elective surgical cases leads to a waste of resources, financial burden, patient dissatisfaction, extended hospital stay, and unnecessary repetition of preoperative preparations. Aim: The objective of this study was to identify, analyze and manage the causes of cancellation of elective surgical cases in our institution. Methods: This quality improvement study compared preoperative cardiovascular event and case cancellation rates before and after implementing the practice of perioperative cardiovascular risk management. The study included the following phases: (1) Screening and identification of the most important reason for case cancellation; (2) Developing the strategy and internal protocol based on the international recommendations to minimize perioperative cardiovascular risk; (3) Implementing the internal protocol and monitoring preoperative cardiovascular events and case cancellation rate. Results: We achieved a reduction in surgical case cancellation rate: 83 (3.7%) out of 2242 in 2018 and 28 (1.1%) out of 2538 cases in 2019 were cancelled after the patient had been delivered to the operating room area. Conclusion: Screening and identification of gaps in perioperative care as well as implementation of evidence-based recommendations can significantly improve the quality of patient care. In our case, implementing the internal protocol of cardiovascular risk management in perioperative period resulted in a reduction of preoperative hypertensive crisis, myocardial ischemia, heart rhythm disorder rates and in subsequently reduction in case cancellation rate.

Case cancelation , Perioperative dysrhythmia , Perioperative hypertension , Perioperative myocardial ischemia

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Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
Department of Anesthesiology and Critical Care, University Medical Center, Nur-Sultan, Kazakhstan
Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States

Department of Biomedical Sciences
Department of Anesthesiology and Critical Care
Department of Anesthesiology

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