A study on reasons for OT cancellations in a multidisciplinary hospital applying quality improvement tools for improving the process

Background of the study: An operation theatre is that the heart of a hospital requiring considerable human resources and expenditure from the hospital budget. However, operation theatres are underutilized and lie idle a number of the time and lots of patients who are involved operation from waiting lists aren't operated upon. Planned operations that are cancelled reflect inefficiency in management and causes inconvenience to patients. Cancellation of operations presents a serious problem in most hospitals. There are many reasons for cancellation of elective surgical cases. Cancellation of cases on the scheduled day of surgery results in inefficient utilization of manpower and scarce resources. It also leads to prolonged hospital stay in many cases. Cancellation of elective scheduled operations on the day of surgery results in an inefficient use of OR (OR) time and a waste of resources. It also causes inconvenience for patients and families. Moreover, day of surgery (DOS) cancellation creates logistic and financial burden related to extended hospital stay and repetitions of pre-operative preparations also as opportunity costs of lost time and missed income, hence with an aim of providing suitable strategies to decrease the cancellation and re-scheduling the present study was undertaken. Aim: To study the common reasons for OT cancellations applying quality improvement tools and to reduce the possible OT cancellations based on the derived reasons. Objectives: 1. To categorize all the OT cancellations under common reasons applying Quality Improvement tools 2. Plan actions to reduce the possible OT cancellations based on the specific reason to facilitate patient safety 3. To comply with Timely OT scheduling Research methodology: Study design: Retrospective study Study methodology: Structure process outcome method Study sample period: Jan-20 to Dec-20 (1year) Study sample size: All OT cancellation (46) during the study period Quality improvement tools applied: 1. Analytical Tool: Pareto chart followed by RCA 2. Statistical Tool: Cause & Effect analysis 3. Managerial Tool: PDSA Source of data: Records maintained in the operation theatre and medical records department in the hospital. The medical records of all the patients, who had their operations cancelled on the day of surgery in all surgical units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented. Results: Based on the reasons decisions were made to prevent the OT cancellation at ward level itself. Consultants were encouraged to post the case only after appropriate fitness. Anesthetist & Surgeon to be informed of the investigation reports immediately on receiving in wards by nursing staff. Major critical reports if suspected by consultant during fitness then case to be scheduled only after reviewing the reports. Checklist to be prepared and followed in wards for planned surgeries with the basic requirements to prevent OT cancellations. Conclusion: OT cancellation in a multidisciplinary hospital can be prevented and controlled by studying the reasons using Quality improvement tools and implementing corrective actions based on the specific reasons derived