Cancelación en CMA: Incidencia y causas / Cancellation in CMA: Incidence and causes

Introducción: Las Unidades de Cirugía Mayor Ambulatoria (UCMA) cada día cobran más relevancia precisando una correcta gestión. Uno de los principales parámetros a mejorar en la política de gestión hospitalaria es el índice de cancelaciones sobre procesos electivos. Material y método Diseñamos un estudio retrospectivo observacional, seleccionando todos los pacientes intervenidos en nuestra UCMA desde 1995 hasta 2009: un total de 16.934 pacientes. Analizamos las intervenciones quirúrgicas canceladas el día anterior a la intervención y las cancelaciones en el día de la intervención. Resultados Un total de 701 pacientes (4,1%) sufrieron la cancelación de la intervención quirúrgica programada. En 343 pacientes (2%) la cancelación se produjo el día anterior a la intervención y en 358 pacientes (2,1%) la cancelación se produjo el día de la intervención. Causas de la cancelación enfermedad aguda intercurrente 180 pacientes (25,7%), decisión personal del paciente 126 (18%), no comparecencia del paciente 28 (4%), preparación incorrecta del paciente 190 (27,1%), falta de recursos 177 (25,2%). Distribuyendo las causas de cancelación según la (..) (AU)

Introduction: Major Ambulatory Surgery (MAS) units are becoming increasingly important and require correct management. One of the principal improvement parameters in hospital management policy is the rate of cancellations of elective surgery. Material and method: We designed a retrospective, observational study by selecting all the patients operated on in our MAS unit from 1995 to 2009: 16.934 patients. We analysed the surgical procedures cancelled the day before the operation. Results: A total of 701 patients (4.1%) had a scheduled surgical intervention cancelled. This cancellation occurred the day before the operation in 343 patients (2%) and on the same day of the operation in 358 patients (2.1%). Reasons for the cancellation: acute intercurrent disease in 180 patients (25.7%), personal decision of the patient in 126 (18%), non-appearance of the patient in 28 (4%), incorrect preparation of the patient in 190 (27.1%), lack of resources (..) (AU)

[Cancellation in CMA: incidence and causes]. / Cancelación en CMA: incidencia y causas.

INTRODUCTION: Major Ambulatory Surgery (MAS) units are becoming increasingly important and require correct management. One of the principal improvement parameters in hospital management policy is the rate of cancellations of elective surgery. MATERIAL AND METHOD: We designed a retrospective, observational study by selecting all the patients operated on in our MAS unit from 1995 to 2009: 16.934 patients. We analysed the surgical procedures cancelled the day before the operation. RESULTS: A total of 701 patients (4.1%) had a scheduled surgical intervention cancelled. This cancellation occurred the day before the operation in 343 patients (2%) and on the same day of the operation in 358 patients (2.1%). Reasons for the cancellation: acute intercurrent disease in 180 patients (25.7%), personal decision of the patient in 126 (18%), non-appearance of the patient in 28 (4%), incorrect preparation of the patient in 190 (27.1%), lack of resources in 177 (25.2%). Distributing the reasons for cancellation according to the possibility of preventing them; 369 cancellations (52.6%) could be avoidable, 43 (6.2%) potentially avoidable, 177 (25.2%) difficult to avoid, and 112 (16%) unavoidable. CONCLUSIONS: More than half of the cancellations could have been avoided. We recommend improvements in the replacement of already scheduled patients. Information campaigns would be needed to increase the awareness of the population on the real cost of health services. Improvement measures would also be needed to improve the selection-evaluation of patients with pre-operative protocols/assessment units.