Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2018, Issue 2


Olguín-Juárez P
Factorial analysis to increase operating room performance and decrease cancellation of elective surgery
Cir Gen 2018; 40 (2)

Language: Español
References: 43
Page: 78-86
PDF: 205.95 Kb.


Full text




ABSTRACT

Introduction: The cancellation of elective surgeries and the low performance of operating room are problems that affect the quality of medical care. Objective: To evaluate the use of factor analysis, to identify the causes of underperformance in the operating room, in order to reduce the rate of surgery cancellation and increase performance. Methods: Through a prospective study; to the staff that works in the operating room, we ask them to write down ten problems that prevent the optimal use of the operating room, adding the solutions they propose; a factorial analysis is performed. With the results an operational decision is taken that is applied at the beginning of the turn. The performance, rate and causes of suspension are identified. Results: Factor analysis identified two related factors: lack of coordination of anesthesiologists and operating room. With an operative decision, a performance of 100% and an elective surgery cancellation rate of 4.9% were obtained. The causes of major cancellation were: lack of surgical time 48.5%, emergency surgery 17.1% and hypertensive patient 10.5%. Conclusion: Factor analysis identified causes that, through an operative decision, increased performance, decreasing the rate of cancellation of elective surgeries to an acceptable range.


Key words: Canceled surgery, operating room performance, factorial analysis.


REFERENCIAS

  1. Galván MA, Flores NG. La suspensión de cirugía programada como un indicador de calidad en la atención hospitalaria. Rev Hosp M Gea Glz. 2006; 7: 59-62.

  2. Leslie RJ, Beiko D, van Vlymen J, Siemens DR. Day of surgery cancellation rates in urology: Identification of modifiables factors. Can Urol Assoc J. 2013; 7: 167-173.

  3. World Health Organization. The financial crisis and global health report of a high-level consultation; Geneva 2009 Jan 19. Available in: http://www.who.int/mediacentre/events/meetings/2009_financial_crisis_report_en_.pdf?ua=1

  4. Villanueva EL. Los adultos mayores. Una mirada al futuro. Rev Hosp Gral Dr M Gea González. 2000; 3: 5-6.

  5. Aguirre-Córdova JF, Chávez-Vázquez G, Huitrón-Aguilar GA, Cortés-Jiménez N. ¿Porqué se suspende una cirugía? Causas, implicaciones y antecedentes bibliográficos. Gac Méd Méx. 2003; 139: 545-551.

  6. División Técnica de Información Estadística en Salud. El IMSS en cifras. Las intervenciones quirúrgicas. Rev Med Inst Mex Seguro Soc. 2005; 43: 511-520.

  7. Pandit JJ, Pandit M, Reynard JM. Understanding waiting lists as the matching of surgical capacity to demand: are we wasting enough surgical time? Anaesthesia. 2010; 65: 625-640.

  8. Betanzos VL. Causas frecuentes de suspensión de cirugía programada en el Hospital Regional de Alta Especialidad Ciudad Salud durante el periodo enero-diciembre de 2013. Evid Med e Invest Salud. 2014; 7: 33.

  9. López J ML, Sastre NO, Ruiz VG, Rodea RH. La suspensión de cirugía electiva en un hospital público de tercer nivel. Frecuencia y causas. Cir Gen. 2008; 30: 34-40.

  10. Dexter F, Maxbauer T, Stout C, Archbold L, Epstein RH. Relative influence on total cancelled operating room time from patients who are inpatients or outpatients preoperatively. Anesth Analg. 2014; 118: 1072-1080.

  11. Rymaruk S. A retrospective observational study of patient cancellations on the day of surgery in the general surgical directorate. J Perioper Pract. 2011;21:337-341.

  12. Kumar R, Gandhi R. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital. J Anaesthesiol Clin Pharmacol. 2012; 28: 66-69.

  13. Moreno-Martínez R, Martínez-Cruz Rocío A. Eficiencia hospitalaria medida por el aprovechamiento del recurso cama en un hospital de segundo nivel de atención. Rev Med Inst Mex Seguro Soc. 2015; 53: 552-557.

  14. Fernández HVM, Sotelo GEM. Los derechos humanos y la salud pública. Rev Fac Med UNAM. 2000; 43: 238-242.

  15. González-Arévalo A, Gómez-Arnau JI, de la Cruz FJ, Marzal JM, Ramírez S, Corral EM y cols. Causes for cancellation of elective surgical procedures in a Spanish general hospital. Anaesthesia. 2009; 64: 487-493.

  16. Sandbaek BE, Helgheim BI, Larsen OI, Fasting S. Impact of changed management policies on operating room efficiency. BMC Health Serv Res. 2014; 14: 224.

  17. Dhafar KO, Ulmalki MA, Felemban MA, Mahfouz ME, Baljoon MJ, Gazzaz ZJ, et al. Cancellation of operations in Saudi Arabian hospitals: frequency, reasons and suggestions for improvements. Pak J Med Sci. 2015; 31: 1027-1032.

  18. Peters JA, Dean HM, Enhancing OR capacity and utilization. Healthc Financ Manage. 2011; 65: 66-71.

  19. Karidis PN, Dimitroulis D, Kouraklis G. Global financial crisis and surgical practice: the Greek paradigm. World J Surg. 2011; 35: 2377-2381.

  20. Peltokorpi A. How do strategic decisions and operative practices affect operating room productivity? Health Care Manag Sci. 2011; 14: 370-382.

  21. Fajardo GO. Hitos en la planeación médica en el IMSS. Rev Med Inst Mex Seguro Soc. 2002; 41: 85-88.

  22. Marjamaa RA, Kirvelä OA. Who is responsible for operating room management and how do we measure how well we do it? Acta Anaesthesiol Scand. 2007; 51: 809-814.

  23. Zheng B, Panton O, Al-Tayeb T. Operative length independently affected by surgical team size: data from 2 Canadian hospitals. Can J Surg. 2012; 55: 371-376.

  24. Marjamaa R, Vakkuri A, Kirvela O. Operating room management: why, how, and by whom? Acta Anaesthesiol Scand. 2008; 52: 596-600.

  25. Persson MJ, Persson JA. Analysing management policies for operating room planning using simulation. Health Care Management Science. 2010; 13: 182-191.

  26. Chang JH, Chen KW, Chen KB, Poon KS, Liu SK. Case review analysis of operating room decisions to cancel surgery. BMC Surg. 2014; 14: 47.

  27. Olguín PJ. Octubre 2010. En Anaya RP Programación dinámica de quirófanos y valoración pre anestésica el día de la hospitalización, para obtener eficiencia quirúrgica en cirugía electiva en un Hospital General de Zona. En Anaya RP. 34o Congreso Internacional de Cirugía General realizado en Guadalajara, Jal México.

  28. Carrada-Bravo T. Desarrollo y usos de la epidemiología clínica. Rev Inst Nal Enf Resp Mex. 2000; 13: 170-179.

  29. Hovlid E, Bukve O, Haug K, Aslaksen AB, von Plessen C. A new pathway for elective surgery to reduce cancellation rates. BMC Health Serv Res. 2012; 12: 154.

  30. Macario A. Are your hospital operating rooms “efficient”? Anesthesiology. 2006; 105: 237-240.

  31. Fajardo-Gutiérrez A, Yamamoto-Kimura LT, Garduño-Espinoza J, Hernández-Hernández DM, Martínez-García MC. Consistencia y validez de una medición en la investigación clínica pediátrica. Definición, evaluación y su interpretación. Bol Méd Hosp Infant Méx. 1991; 48: 367-381.

  32. Agnoletti V, Buccioli M, Padovani E, Corso RM, Perger P, Piraccini E, et al. Operating room data management: improving efficiency and safety in a surgical block. BMC Surg. 2013; 13: 7.

  33. Kargar ZS, Khanna S, Sattar A. Using prediction to improve elective surgery scheduling. Australas Med J. 2013; 6: 287-289.

  34. Fixler T, Wright JG. Identification and use of operating room efficiency indicators: the problem of definition. Can J Surg. 2013; 56: 224-226.

  35. Mesmar M, Shatnawi NJ, Khader YS. Reasons for cancellation of elective operations at a major teaching referral hospital in Jordan. East Mediterr Health J. 2011; 17: 651-655.

  36. Heller J, Murch P. Development in service provision. Making major elective surgery happen. The development of a postoperative surgical unit. Nurs Crit Care. 2008; 13: 97-104.

  37. Gaucher S, Boutron I, Marchand -Maillet F, Baron G, Douard R, Bethoux J-P, et al. Assessment of a standardized pre-operative telephone checklist designed to avoid late cancellation of ambulatory surgery: the AMBUPROG multicenter randomizedcontrolled trial. PLoS One. 2016; 11: e0147194.

  38. Pandit JJ, Carey A. Estimating the duration of common elective operations: implications for operating list management. Anaesthesia. 2006; 61: 768-776.

  39. He W, Ni S, Chen G, Jiang X, Zheng B. The composition of surgical teams in the operating room and its impact on surgical team performance in china. Surg Endosc. 2014; 28: 1473-1478.

  40. Heng M, Wright JG. Dedicated operating room for emergency surgery improves access and efficiency. Can J Surg. 2013; 56: 167-174.

  41. Emanuel A, Macpherson R. The anaesthetic pre-admission clinic is effective in minimising surgical cancellaton rates. Anaesth Intensive Care. 2013; 41: 90-94.

  42. Gheysari E, Yousefi H, Soleymani H, Mojdeh S. Effect of six sigma program on the number of surgeries cancellation. Iran J Nurs Midwifery Res. 2016; 21: 191-196.

  43. Yoon SZ, Lee SI, Lee WH, Lim HJ, Yoon SM, Chan SH. The effect of increasing operating room capacity on day-of-surgery cancellation. Anaesth Intensive Care. 2009; 37: 261-266.






>Journals >Cirujano General >Year 2018, Issue 2
 

· Journal Index 
· Links 






       
Copyright 2019