Limits...
Bed crisis and elective surgery late cancellations: An approach using the theory of constraints.

Sahraoui A, Elarref M - Qatar Med J (2014)

Bottom Line: Simple and systematic analysis of these attributes typically provides limited solutions to the cancellation problem.Alternatively, the application of the theory of constraints with its five focusing steps, which analyze the system in its totality, is more likely to provide a better solution to the cancellation problem.To find the constraint, as a first focusing step, we carried out a retrospective and descriptive study using a quantitative approach combined with the Pareto Principle to find the main causes of cancellations, followed by a qualitative approach to find the main and ultimate underlying cause which pointed to the bed crisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Intensive Care, Pain and Palliative Care, Hamad Medical Corporation - Hamad General Hospital, Doha, Qatar.

ABSTRACT
Late cancellations of scheduled elective surgery limit the ability of the surgical care service to achieve its goals. Attributes of these cancellations differ between hospitals and regions. The rate of late cancellations of elective surgery conducted in Hamad General Hospital, Doha, Qatar was found to be 13.14% which is similar to rates reported in hospitals elsewhere in the world; although elective surgery is performed six days a week from 7:00 am to 10:00 pm in our hospital. Simple and systematic analysis of these attributes typically provides limited solutions to the cancellation problem. Alternatively, the application of the theory of constraints with its five focusing steps, which analyze the system in its totality, is more likely to provide a better solution to the cancellation problem. To find the constraint, as a first focusing step, we carried out a retrospective and descriptive study using a quantitative approach combined with the Pareto Principle to find the main causes of cancellations, followed by a qualitative approach to find the main and ultimate underlying cause which pointed to the bed crisis. The remaining four focusing steps provided workable and effective solutions to reduce the cancellation rate of elective surgery.

No MeSH data available.


Reasons of cancellation.
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Related In: Results  -  Collection


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fig2: Reasons of cancellation.

Mentions: Some of the most common causes of cancellation were: over-booking, patient no-show, unfit for anesthesia, and unfit for surgery. Those results represented the most frequent causes of late cancellation (Table 5) as represented by the breakpoint of the Pareto chart (Figure 2). Our causative approach demonstrated that patients were the source of cancellations in 55.8% of cases followed by the surgeon 31.4% and the hospital 12.8%.


Bed crisis and elective surgery late cancellations: An approach using the theory of constraints.

Sahraoui A, Elarref M - Qatar Med J (2014)

Reasons of cancellation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4197367&req=5

fig2: Reasons of cancellation.
Mentions: Some of the most common causes of cancellation were: over-booking, patient no-show, unfit for anesthesia, and unfit for surgery. Those results represented the most frequent causes of late cancellation (Table 5) as represented by the breakpoint of the Pareto chart (Figure 2). Our causative approach demonstrated that patients were the source of cancellations in 55.8% of cases followed by the surgeon 31.4% and the hospital 12.8%.

Bottom Line: Simple and systematic analysis of these attributes typically provides limited solutions to the cancellation problem.Alternatively, the application of the theory of constraints with its five focusing steps, which analyze the system in its totality, is more likely to provide a better solution to the cancellation problem.To find the constraint, as a first focusing step, we carried out a retrospective and descriptive study using a quantitative approach combined with the Pareto Principle to find the main causes of cancellations, followed by a qualitative approach to find the main and ultimate underlying cause which pointed to the bed crisis.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Intensive Care, Pain and Palliative Care, Hamad Medical Corporation - Hamad General Hospital, Doha, Qatar.

ABSTRACT
Late cancellations of scheduled elective surgery limit the ability of the surgical care service to achieve its goals. Attributes of these cancellations differ between hospitals and regions. The rate of late cancellations of elective surgery conducted in Hamad General Hospital, Doha, Qatar was found to be 13.14% which is similar to rates reported in hospitals elsewhere in the world; although elective surgery is performed six days a week from 7:00 am to 10:00 pm in our hospital. Simple and systematic analysis of these attributes typically provides limited solutions to the cancellation problem. Alternatively, the application of the theory of constraints with its five focusing steps, which analyze the system in its totality, is more likely to provide a better solution to the cancellation problem. To find the constraint, as a first focusing step, we carried out a retrospective and descriptive study using a quantitative approach combined with the Pareto Principle to find the main causes of cancellations, followed by a qualitative approach to find the main and ultimate underlying cause which pointed to the bed crisis. The remaining four focusing steps provided workable and effective solutions to reduce the cancellation rate of elective surgery.

No MeSH data available.