Background
Methods
Study design and setting
Results
Patient (n = 46 or 17.6 %) • Patient did not show up for surgery (n = 29) • Patient changed mind about surgery (n = 7) • Patient had a panic attack (n = 1) • Patient refused surgery (n = 4) • Patient’s family refused surgery (n = 2) • Patient left against medical advice (n = 1) • Patient Postponed (n = 2) | Resource/Facility (n = 52 or 19.9 %) • OR behind schedule (n = 23) • Equipment broken or not available (n = 6) • Implant(s) not available (n = 1) • Emergency/life-saving case prioritized (n = 3) • Scheduling error (n = 5) • Staff miscommunication (n = 13) • Pre-operative instruction not communicated properly to patient (n = 1) |
Workup/Medical condition (n = 85 or 32.6 %) • Change in medical status (n = 31) • Incomplete Surgical-work up (n = 4) • Incomplete Medical evaluation (n = 34) • Abnormal test (n = 5) • Change in treatment plan (n = 6) • Difficult unobtainable IV access (n = 1) • Pre-operative instructions not followed properly (n = 4) | Surgeon (n = 7 or 2.7 %) • Surgeon not available (n = 4) • Surgeon sick (n = 1) • Surgeon was operating in another hospital (n = 1) • Surgeon was travelling (n = 1) |
Admission (n = 50 or 19.2 %) • No Financial Clearance (n = 43) • Papers not ready (n = 7) | Bed (n = 21 or 8 %) • No private bed available (n = 3) • No government-contracted bed available (n = 17) • No cardiac surgery unit bed (n = 1) |
Avoidable (n = 187or 71.6 %) | Unavoidable (n = 74or 28.4 %) | |
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Hospital Related (n = 174 or 66.7 %) | ▪ Incomplete surgical-work up (n = 4) ▪ Incomplete medical evaluation (n = 34) ▪ Staff miscommunication (n = 13) ▪ No financial clearance (n = 43) ▪ Admission papers not ready (n = 7) ▪ OR behind schedule (n = 23) ▪ Scheduling error (n = 5) ▪ Implants not available (n = 1) ▪ No bed available (n = 21) ▪ Equipment unavailable (n = 6) ▪ Patient not instructed appropriately to stop drinking water (n = 1) | ▪ Change in treatment plan (n = 6) ▪ Emergency/life-saving case that occupied the OR (n = 3) ▪ Surgeon not available (n = 4) ▪ Surgeon was operating in another hospital (n = 1) ▪ Surgeon was travelling (n = 1) ▪ Surgeon sick (n = 1) |
Patient Related (n = 87 or 33.3 %) | ▪ Patient did not show up for surgery (n = 29) | ▪ Change in medical status (n = 31) ▪ Abnormal test (n = 5) ▪ Difficult unobtainable IV access (n = 1) ▪ Patient family refused surgery (n = 2) ▪ Patient postponed (n = 2) ▪ Patient left against medical advice (n = 1) ▪ Patient changed mind about surgery while in hospital (n = 7) ▪ Patient had a panic attack (n = 1) ▪ Patient refused surgery (n = 4) ▪ Preoperative instructions not followed properly (n = 4) |