Can preoperative anesthesia consultation clinic help to reduce operating room cancellation rate of cardiac surgery on the day of surgery?

Abstract

Background: Many surgical procedures are delayed or cancelled due to inadequate preoperative assessment and preparation. Case cancellations can be decreased by improved preoperative patient evaluation, improved communication between physician and patient, and modified schedule design. Because of importance of the high cost associated with operating room cancellations; healthcare providers have exerted efforts to decrease case cancellations on the day of surgery. The aim of this study was to evaluate the role of"pre-anesthesia consultation clinic" in reducing operating room cancellation.

Methods: We prospectively studied cancellation rate in 1716 scheduled cases for open heart surgery during a 4 months period in a teaching hospital. Of the 1716 patients, 866 cases were scheduled for operation before establishment of pre-anesthesia consultation clinic (Group 1) and 850 cases were scheduled after establishment of those clinics (Group 2). The data collected included patient age, ASA physical status and date of the preoperative assessment.

Results: Of the 1716 patients studied, 15.03% of cases were cancelled in the two groups. Cancellation rate in Group 1 was 146 (16.8%) and cancellation rate in Group 2 was 113 (13.29%). This difference was statistically significant (p = 0.046). The most common cause of cancellation in the two groups was incomplete medical work-up (32%) [group 1 (19.8%) more than group 2 (12.6%)].

Conclusion: Since the most common cause of cancellation in the two groups was incomplete medical work-up, then visitation of patients to the pre-anesthesia consultation clinic would minimize cancellation rate on the day of surgery.