Causes of postponement of elective surgery in Mayo hospital Lahore

ABSTRACT

Elective surgery is an important part of a hospital's workload. Whenever a case is put on list, it involves interaction of a number of people and in the same way its postponement affects many parties. The purpose of this study was to highlight the causes of such postponements, their impact on the hospital and to devise an approach to avoid preventable causes. This study was conducted in two operation theatres of Mayo Hospital Lahore over a period of one year i.e. from April 2009 to May 2010. All the patients scheduled to undergo elective surgical procedures in these operation theatres were included. Total number of cases, number of cancellations as well as causes of cancellation were noted. A total 0/252 lists were planned in both theaters and 2394 patients were put on list. Among this total number the operations 0/179 patients [7.47%] were postponed. The highest proportion of postponements was due to time constraints [35.75%]. Other main reasons were patients with uncontrolled blood pressure and cardiac problems [15.08%], treatment of blast victims [11.17%], strikes of the staff [8.37%] and non-availability of ICU bed / ventilator inaddition [5.58%] there were other less common causes as well. As a large proportion of postponements was due to mismanagement of the list time, it was therefore clear that there was lack of proper list planning and unrealistic time allotment for cases. This led to a large number of cancellations at the end of the day. This can be easily prevented by keeping in mind a rough time span taken by each procedure and calculating the total number of cases possible on each table