Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants_West China Medical Journal

Authors：

XU Lei ^1,2 , NIU Mingming ^1,2 , GAO Boxin ^1,2 , YU Deliang ^1,2 , YU Peihua ^1,2 ,  LIU Xiaonan ^1,2

1. Day Surgery Center, the First Affiliated Hospital of the Air Force Military Medical University, Xi’an, Shaanxi 710032, P. R. China;
2. Ambulatory Care Management Medical Quality Control Center of Shaanxi Province, Xi’an, Shaanxi 710032, P. R. China;

Corresponding?author：

LIU Xiaonan, Email: 15353589999@163.com

Keywords：

Ambulatory surgery; doctor-patient assistant; surgical cancellation

DOI：

10.7507/1002-0179.202311286

Video：

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Objective To investigate the cancellation of ambulatory surgeries based on doctor-patient assistants, analyze the reasons, and propose corresponding strategies in order to improve the utilization of medical resources and the operational efficiency of hospitals. Methods A retrospective analysis was conducted on patient data between May 2021 and October 2023, who successfully scheduled surgery at the Day Surgery Center of the First Affiliated Hospital of the Air Force Military Medical University and cancelled the surgery due to various reasons. The reasons for the cancellation were also analyzed. Results A total of 5691 surgeries were scheduled, and 27 surgeries were cancelled before admission, with a cancellation rate of 0.47%. A total of 5607 surgeries were completed, and 57 surgeries were cancelled on the day of surgery, with a cancellation rate of 1.01%. Among all departments, patients in Gastrointestinal Surgery Department and Urology Department had the highest cancellation rates before admission (1.61% and 0.68%, respectively), and the highest cancellation rates on the day of surgery (1.43% and 1.38%, respectively). The most common reason for cancellation before admission was surgical doctor business travel/other arrangements (22.22%). The most common reason for cancellation on the day of surgery was preoperative respiratory infections in patients (14.04%). Conclusions The establishment of doctor-patient assistant positions can to some extent help reduce the cancellation of ambulatory surgery before admission and on the day of surgery. For patients undergoing ambulatory surgery, preoperative education and evaluation should be strengthened, and management processes and systems should be improved, in order to reduce the cancellation rate of ambulatory surgery and improve hospital operational efficiency.

Citation： XU Lei, NIU Mingming, GAO Boxin, YU Deliang, YU Peihua, LIU Xiaonan. Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants. West China Medical Journal, 2024, 39(2): 217-221. doi: 10.7507/1002-0179.202311286 Copy

1.	Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2.	嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 2020, 40(2): 199-202.
3.	于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
4.	徐蕾, 劉小南, 俞德梁, 等. 基于日間模式的手術患者當日出院的影響因素分析. 華西醫學, 2022, 37(2): 194-198.
5.	陸曄峰, 林靖怡, 馮佳琪, 等. 日間手術護理管理的研究進展. 護理研究, 2018, 32(10): 1499-1503.
6.	楊思捷, 楊珂璐, 田小合, 等. 基于國際日間手術協會年會摘要熱點主題的聚類分析和循證可視化研究. 中國實用外科雜志, 2022, 42(12): 1408-1415, 1427.
7.	焦雅輝. 中國日間手術發展報告(2020). 北京: 北京大學醫學出版社, 2020: 1.
8.	張沁青, 譚耘. 降低日間手術當日取消率的品管圈實踐. 護理學報, 2020, 27(9): 19-22.
9.	楊陳, 張學兵, 敖偉, 等. 兒童日間手術當日手術取消的原因分析及對策. 護理學雜志, 2018, 33(6): 74-76.
10.	Williams OM, Faboya OM, Omisanjo OA. Parental post-operative telephone follow-up after paediatric day case surgery. World J Surg, 2021, 45(10): 3222-3229.
11.	俞德梁, 劉小南, 高博欣, 等. 醫患助理助力提升圍手術期管理質量. 中國衛生質量管理, 2021, 28(5): 34-35, 43.
12.	俞德梁, 劉小南, 高博欣, 等. 計劃性手術模式: 日間手術管理的新實踐. 中國衛生質量管理, 2021, 28(7): 37-39, 47.
13.	劉茜, 黃明君, 馬洪升, 等. 日間手術取消原因分析及對策. 華西醫學, 2022, 37(9): 1352-1357.
14.	奚春花, 施東婧, 李蕓慧, 等. 非白內障眼科日間手術當日取消率及原因分析. 中華醫學雜志, 2022, 102(21): 1608-1613.
15.	李詩涵, 劉芳, 杜姣姣, 等. 日間手術患者當日取消手術原因分析及改進建議. 中國衛生質量管理, 2019, 26(4): 45-47.
16.	Wong DJN, Harris SK, Moonesinghe SR, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK national health service hospitals. Br J Anaesth, 2018, 121(4): 730-738.
17.	孫輝, 明敏馨, 馬旭東. 我國二、三級醫療機構日間手術發展現狀分析. 中國醫院管理, 2022, 42(3): 48-51.
18.	俞德梁, 劉小南. 日間手術發展展望. 醫學與哲學, 2022, 43(22): 61-64.
19.	俞德梁, 劉小南. 我國日間手術政策文件的可視化分析. 中國衛生質量管理, 2022, 29(10): 31-34.
20.	顧靜, 李婷. 個案管理師為主導的婦科日間手術護理流程的實施. 護理學雜志, 2019, 34(17): 21-24.
21.	楊艷英, 何梅, 陳熙, 等. 醫生助理崗位應用于日間腹腔鏡膽囊切除術的效果分析. 中國衛生質量管理, 2022, 29(10): 53-57.
22.	Abate SM, Chekole YA, Minaye SY, et al. Global prevalence and reasons for case cancellation on the intended day of surgery: a systematic review and meta-analysis. Int J Surg Open, 2020, 26: 55-63.
23.	程純, 徐曉波, 楊柳, 等. 691 例住院患者擇期手術取消原因分析和對策建議. 中國病案, 2017, 18(4): 35-39.
24.	Xu L, Ma Y, Wang S, et al. Incidence of gastrointestinal stromal tumor in Chinese urban population: a national population-based study. Cancer Med, 2021, 10(2): 737-744.

1. Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2. 嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 2020, 40(2): 199-202.
3. 于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
4. 徐蕾, 劉小南, 俞德梁, 等. 基于日間模式的手術患者當日出院的影響因素分析. 華西醫學, 2022, 37(2): 194-198.
5. 陸曄峰, 林靖怡, 馮佳琪, 等. 日間手術護理管理的研究進展. 護理研究, 2018, 32(10): 1499-1503.
6. 楊思捷, 楊珂璐, 田小合, 等. 基于國際日間手術協會年會摘要熱點主題的聚類分析和循證可視化研究. 中國實用外科雜志, 2022, 42(12): 1408-1415, 1427.
7. 焦雅輝. 中國日間手術發展報告(2020). 北京: 北京大學醫學出版社, 2020: 1.
8. 張沁青, 譚耘. 降低日間手術當日取消率的品管圈實踐. 護理學報, 2020, 27(9): 19-22.
9. 楊陳, 張學兵, 敖偉, 等. 兒童日間手術當日手術取消的原因分析及對策. 護理學雜志, 2018, 33(6): 74-76.
10. Williams OM, Faboya OM, Omisanjo OA. Parental post-operative telephone follow-up after paediatric day case surgery. World J Surg, 2021, 45(10): 3222-3229.
11. 俞德梁, 劉小南, 高博欣, 等. 醫患助理助力提升圍手術期管理質量. 中國衛生質量管理, 2021, 28(5): 34-35, 43.
12. 俞德梁, 劉小南, 高博欣, 等. 計劃性手術模式: 日間手術管理的新實踐. 中國衛生質量管理, 2021, 28(7): 37-39, 47.
13. 劉茜, 黃明君, 馬洪升, 等. 日間手術取消原因分析及對策. 華西醫學, 2022, 37(9): 1352-1357.
14. 奚春花, 施東婧, 李蕓慧, 等. 非白內障眼科日間手術當日取消率及原因分析. 中華醫學雜志, 2022, 102(21): 1608-1613.
15. 李詩涵, 劉芳, 杜姣姣, 等. 日間手術患者當日取消手術原因分析及改進建議. 中國衛生質量管理, 2019, 26(4): 45-47.
16. Wong DJN, Harris SK, Moonesinghe SR, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK national health service hospitals. Br J Anaesth, 2018, 121(4): 730-738.
17. 孫輝, 明敏馨, 馬旭東. 我國二、三級醫療機構日間手術發展現狀分析. 中國醫院管理, 2022, 42(3): 48-51.
18. 俞德梁, 劉小南. 日間手術發展展望. 醫學與哲學, 2022, 43(22): 61-64.
19. 俞德梁, 劉小南. 我國日間手術政策文件的可視化分析. 中國衛生質量管理, 2022, 29(10): 31-34.
20. 顧靜, 李婷. 個案管理師為主導的婦科日間手術護理流程的實施. 護理學雜志, 2019, 34(17): 21-24.
21. 楊艷英, 何梅, 陳熙, 等. 醫生助理崗位應用于日間腹腔鏡膽囊切除術的效果分析. 中國衛生質量管理, 2022, 29(10): 53-57.
22. Abate SM, Chekole YA, Minaye SY, et al. Global prevalence and reasons for case cancellation on the intended day of surgery: a systematic review and meta-analysis. Int J Surg Open, 2020, 26: 55-63.
23. 程純, 徐曉波, 楊柳, 等. 691 例住院患者擇期手術取消原因分析和對策建議. 中國病案, 2017, 18(4): 35-39.
24. Xu L, Ma Y, Wang S, et al. Incidence of gastrointestinal stromal tumor in Chinese urban population: a national population-based study. Cancer Med, 2021, 10(2): 737-744.

West China Medical Journal

Analysis of reasons for cancellation of ambulatory surgery based on doctor-patient assistants

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