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Shi Y, Yan J, Wang S, Li Y, Deng X. Efficacy of a new day surgery management mode based on WeChat: a study protocol for randomised controlled trials. BMJ Open 2022; 12:e058204. [PMID: 35926989 PMCID: PMC9358948 DOI: 10.1136/bmjopen-2021-058204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION There is an enormous imbalance between the rapid development of day surgery and the current conventional medical services. Hence, an effective day surgery management mode should be developed that can be used to constantly follow up on patients both preoperatively and postoperatively. In this study, WeChat was chosen as the platform. This study aimed to investigate the feasibility and effectiveness of a new day surgery management mode. METHODS AND ANALYSIS This randomised controlled study investigated the efficacy of a new day surgery management mode based on WeChat. The target number of participants was 1000 per group. The application (app) will send personalised information based on the medical history of the patient and the type of surgery at different time points preoperatively and postoperatively. The healthcare worker can follow up the patient and acquire clinical data by simply signing into the app. The patient and the healthcare worker can also engage in video or voice chats using the app when necessary. Multiple departments, including anaesthesiology, internal medicine, surgery, nursing and psychology, will participate in this new mode. ETHICS AND DISSEMINATION Ethical approval was obtained from the West China Hospital of Sichuan University Biomedical Research Ethics Committee. Results of this study will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER ChiCTR2100050793.
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Affiliation(s)
- Yun Shi
- Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China
| | - Junyu Yan
- Department of Anesthesiology, Karamay Hospital of Integrated Traditional Chinese and Western Medicine, Karamay, Xinjiang Uyghur, China
| | - Shuangwen Wang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yifan Li
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqian Deng
- Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, Sichuan, China
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2
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Viftrup A, Dreyer P, Nikolajsen L, Holm A. Surgery cancellation: A scoping review of patients' experiences. J Clin Nurs 2020; 30:357-371. [PMID: 33258277 DOI: 10.1111/jocn.15582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/27/2020] [Accepted: 11/21/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To review the literature on patients' experiences of surgery cancellation to gain knowledge of nursing care needs and identify gaps in evidence. BACKGROUND Surgery cancellations are an ongoing challenge in healthcare systems with negative impacts on healthcare costs, hospital staff and patients. Most research addresses the reasons for cancellation and implementation of preventive interventions, but limited knowledge exists about patients' experiences of cancellation. DESIGN The scoping review was undertaken using the methodology recommended by the Joanna Briggs Institute for Scoping Reviews and the Reporting Cheklist for Scoping Reviews (PRISMA-ScR). METHODS A systematic search was conducted by two independent researchers in Cochrane Library, CINAHL, PubMed and PsycINFO. A forward and backward citation search was performed in Scopus, and references in relevant studies were explored. The tool Covidence was applied to select, compare and discuss relevant articles. The Mixed Methods Appraisal Tool was used for critical appraisal. RESULTS Surgery cancellation is emotionally harmful with negative effects on patients. Four themes were identified: 'Initial reactions to cancellation', 'Reactions during a new waiting period at home and during readmission to hospital', 'Information about cancellation' and 'The experience of new practical arrangements'. Patients whose surgery was cancelled experienced initial feelings such as anger, rejection and anxiety and physical/psychosomatic symptoms in the extended waiting period. Patients prefered early sufficient information about cancellation from the surgeon. The practical arrangements were stressfull for the patients. CONCLUSION Nursing care and identification of vulnerable patients are essential to prevent negative effects in the extended waiting period. Provision of timely, sufficient and professional information about cancellation from the surgeon is important. Further research assessing consequences of cancellation is needed. RELEVANCE TO CLINICAL PRACTICE Patients would benefit if hospitals find systems to minimise cancellation, and healthcare professionals could systematically develop professional supportive interventions tailored to patients' individual needs.
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Affiliation(s)
- Anette Viftrup
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Dreyer
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,Bergen University, Bergen, Norway
| | - Lone Nikolajsen
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anna Holm
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
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Peuchot J, Allard E, Dureuil B, Veber B, Compère V. Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study. JMIR Mhealth Uhealth 2020; 8:e14346. [PMID: 32909948 PMCID: PMC7516679 DOI: 10.2196/14346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/24/2019] [Accepted: 05/14/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. OBJECTIVE The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. METHODS We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. RESULTS A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. CONCLUSIONS In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.
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Affiliation(s)
- Jeremy Peuchot
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | | | - Bertrand Dureuil
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Benoit Veber
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Vincent Compère
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France.,Day Surgery Unit, Rouen University Hospital, France.,Normandie University, Institut National de la Santé et de la Recherche Médicale Unité 982, Rouen, France
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Matzek LJ, Smith BB, Mauermann WJ, Bower TC, Smith MM. Same-Day Cancellation in Vascular Surgery: 10-Year Review at a Large Tertiary Care Center. Ann Vasc Surg 2020; 62:349-355. [DOI: 10.1016/j.avsg.2019.06.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
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Herbert L, Ribar A, Mitchell S, Phillips C. Discovering metformin-induced vitamin B12 deficiency in patients with type 2 diabetes in primary care. J Am Assoc Nurse Pract 2019; 33:174-180. [PMID: 31651584 DOI: 10.1097/jxx.0000000000000312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 07/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although metformin is the preferred initial pharmacological choice in type 2 diabetes, there is evidence that reveals a link between metformin use and vitamin B12 deficiency. The American Diabetes Association (ADA) has recently recommended periodic measurement of B12 levels for all patients on metformin. LOCAL PROBLEM Medical record data collected for the preintervention period showed that only 5% (n = 23) of patients diagnosed with diabetes and on metformin had B12 levels checked at an internal medicine primary care practice. METHODS This was a quasi-experimental project of preintervention and postintervention design using a checklist containing important measures of diabetes control. The project sample population consisted of data of adults with type 2 diabetes aged 18 years and older who were prescribed metformin in the previous year at the primary care practice. INTERVENTIONS The intervention focused on revising an existing diabetes measures checklist to include a prompt for an annual measurement of B12 levels. RESULTS There was significant improvement in monitoring vitamin B12 levels and discovery of low vitamin B12 levels. These data show that the number of B12 levels checked increased from 23 during the preintervention to 155 during the intervention (p ≤ 0.0000). CONCLUSIONS This project supports a conclusion that including a prompt to check B12 levels to an existing checklist increases B12 monitoring in this patient population. Results may encourage other providers to follow the ADA guidelines for monitoring vitamin B12 levels for patients taking metformin.
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Affiliation(s)
- Laura Herbert
- Midlands Internal Medicine, Columbia, South Carolina
- University of South Carolina, College of Nursing, Columbia, South Carolina
| | - Alicia Ribar
- University of South Carolina, College of Nursing, Columbia, South Carolina
| | - Sheryl Mitchell
- University of South Carolina, College of Nursing, Columbia, South Carolina
| | - Cynthia Phillips
- Midlands Internal Medicine, Columbia, South Carolina
- University of South Carolina, College of Pharmacy, Columbia, South Carolina
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Kheir M, Rondon AJ, Bonaddio V, Tan TL, Wang C, Purtill JJ, Courtney PM. Perioperative Telephone Encounters Should Be Included in the Relative Value Scale Update Committee Review of Time Spent on Total Hip and Knee Arthroplasty. J Arthroplasty 2019; 34:1563-1569. [PMID: 31133427 DOI: 10.1016/j.arth.2019.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Providing care for patients undergoing hip and knee arthroplasty requires substantial effort beyond the actual replacement surgery to ensure a safe, clinical, and economically effective outcome. Recently, the Centers for Medicare and Medicaid Services has stated that the procedural codes for total hip (THA) and total knee arthroplasty (TKA) are potentially misvalued and has asked for a review by the Relative Value Scale Update Committee (RUC). The purpose of this study is to quantify one of the additional work efforts associated with telephone encounters during the perioperative episode of care. METHODS We retrospectively reviewed all 47,841 telephone calls from patients to our office from 2015 to 2017 in a consecutive series of 3309 patients who underwent TKA and 3651 patients who underwent THA. We recorded reasons for communication, amount of communication, and the caller identity for both 30 days preoperatively and 90 days postoperatively. We then used the RUC Building Block Method to calculate the preservice and postservice work included in a review of the time and intensity of the codes for THA and TKA. RESULTS The average number of preoperative patient calls per patient was 2.31 for TKA and 2.44 for THA, and the average number of postoperative calls was 5.01 for TKA and 4.00 for THA. The most common reasons for patient calls were perioperative care instructions, medications, medical clearance, paperwork/insurance, and complications. Using the RUC-approved work relative value units (wRVUs) assigned to each telephone encounter, an additional 1.83 wRVUs for perioperative telephone encounters for TKA and 1.61 for THA should be assigned. CONCLUSIONS Providing patients with appropriate support during the arthroplasty episode of care requires substantial telephonic support, which should be acknowledged. As the RUC considers reviewing the time and intensity spent on perioperative care for patients undergoing THA and TKA, they should consider appropriately documenting the amount of work required for telephone communication.
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Affiliation(s)
- Matthew Kheir
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | | | - Vincenzo Bonaddio
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Timothy L Tan
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | | | - James J Purtill
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
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Same-Day Cancellation in Ambulatory Surgery: A Retrospective Review at a Large Academic Tertiary Referral Center. J Ambul Care Manage 2019; 41:118-127. [PMID: 29474251 DOI: 10.1097/jac.0000000000000226] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although ambulatory surgery offers patients convenience and reduced costs, same-day cancellation of ambulatory surgery negatively affects patient experiences and operational efficiency. We conducted a retrospective analysis to determine the frequency and reasons for same-day cancellations in an outpatient surgery center at a large academic tertiary referral center. Of 41 389 ambulatory surgical procedures performed, same-day cancellations occurred at a rate of 0.5% and were usually unforeseeable in nature. Focusing on foreseeable cancellations offers opportunities for enhanced patient satisfaction, improved quality of care, and systems-based practice improvements to mitigate cancellations related to areas such as scheduling or patient noncompliance.
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Análisis retrospectivo de las suspensiones quirúrgicas y de los factores influyentes durante 8 años. Cir Esp 2019; 97:213-221. [DOI: 10.1016/j.ciresp.2019.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/03/2019] [Accepted: 01/12/2019] [Indexed: 11/17/2022]
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Turunen E, Miettinen M, Setälä L, Vehviläinen-Julkunen K. Elective Surgery Cancellations During the Time Between Scheduling and Operation. J Perianesth Nurs 2019; 34:97-107. [DOI: 10.1016/j.jopan.2017.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 11/25/2022]
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10
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Improving outcomes in ambulatory anesthesia by identifying high risk patients. Curr Opin Anaesthesiol 2018; 31:659-666. [DOI: 10.1097/aco.0000000000000653] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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11
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Mayro EL, Pizzi LT, Hark LA, Murchison AP, Wisner D, Koka A, Leiby BE, Dabbish N, Okulate A, Dessy A, Green C, Bailey R. A Proposed Intervention to Decrease Resident-Performed Cataract Surgery Cancellation in a Tertiary Eye Care Center. AMERICAN HEALTH & DRUG BENEFITS 2018; 11:480-487. [PMID: 30746019 PMCID: PMC6322594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 06/15/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cataracts are the leading cause of preventable blindness globally. As a result, competence in cataract surgery is an important component of ophthalmology residency training. Residency programs must optimize the number of cataract surgery cases to train proficient physicians. However, the rate of cataract surgery cancellations is high, and some are canceled because of preventable causes. OBJECTIVE To evaluate the effect of mandatory on-site preadmission testing, including having a physical examination, on resident-performed cataract surgery cancellation rates. METHODS For this study, patients scheduled for cataract surgery at the Wills Eye Hospital resident cataract clinic between January 2015 and November 2015 were enrolled and randomized into 2 groups: usual care or intervention. The patients randomized to the usual care group were instructed to complete preadmission testing and to have a physical examination with their primary care physician. The patients randomized to the intervention group were escorted to a Wills Eye Hospital-affiliated cardiologist to complete preadmission testing and to have a physical examination. Patients in both groups received a reminder call before the cataract surgery. RESULTS A total of 441 patients were included in the study-240 patients in the usual care group and 201 patients in the intervention group. The overall cataract surgery cancellation rate was 14.5%; the rate was 12.4% in the intervention group and 16.3% in the usual care group (P = .28). The patients receiving the intervention were more likely to have preadmission testing and a physical examination than the patients in the usual care arm (P <.001). CONCLUSIONS Facilitating the completion of preadmission testing for patients decreased the rates of resident-performed cataract surgery cancellation at a Wills Eye Hospital resident clinic and has the potential to improve patient outcomes and prevent blindness.
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Affiliation(s)
- Eileen L Mayro
- Research Coordinator, Department of Research, Wills Eye Hospital, Philadelphia, PA, and Student, Sidney Kimmel Medical College, Thomas Jefferson University (TJU), Philadelphia
| | - Laura T Pizzi
- Professor and Director, Center for Health Outcomes, Policy, and Economics, Rutgers University, Piscataway, NJ
| | - Lisa A Hark
- Director, Department of Research, Wills Eye Hospital, and Professor of Ophthalmic Sciences (Ophthalmology), Columbia University Vegalos College of Physicians and Surgeons, New York, NY
| | - Ann P Murchison
- Attending Surgeon and Director, Emergency Department, Wills Eye Hospital, and Associate Professor of Ophthalmology, Sidney Kimmel Medical College, TJU
| | - Douglas Wisner
- Attending Surgeon, Cataract and Primary Eye Care Service, Wills Eye Hospital
| | - Anish Koka
- Attending Physician, Koka Cardiology, TJU
| | - Benjamin E Leiby
- Associate Professor and Director, Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, TJU
| | - Nooreen Dabbish
- Biostatistician, Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, TJU
| | | | - Alexa Dessy
- Students, all at Sidney Kimmel Medical College, TJU
| | | | - Robert Bailey
- Attending Surgeon and Director, Cataract and Primary Eye Care Service, Wills Eye Hospital and Professor of Ophthalmology, Sidney Kimmel Medical College, TJU
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Al Talalwah N, McIltrot KH, Al Ghamdi A. Elective Surgical Cancellations in a Tertiary Hospital in the Middle East: Quality Improvement Process. J Perianesth Nurs 2018; 34:310-321. [PMID: 30217669 DOI: 10.1016/j.jopan.2018.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 01/13/2018] [Accepted: 05/09/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Cancellation of elective surgery negatively affects patient outcomes and the efficiency of the work environment. The purpose of this project was to analyze the cancellation of elective surgeries and identify the best evidence-based interventions to address cancellations in a tertiary hospital in the Middle East. DESIGN A quality improvement study design. METHODS A retrospective review of cancellations conducted over two 3-month periods in 2016 and 2017. FINDINGS In both phases of the audit, patient-related reasons were the leading cause of cancellations. Conducting a preoperative call 2 days before surgery and doing a weekly review of the surgery schedule reduced cancellations from 3.8% to 3.5%. Cancellations because of patient-related reasons reduced from 81% to 79.7% whereas cancellations because of hospital-related reasons reduced from 17.5% to 15.9%. CONCLUSIONS Cancellation of surgeries is a worldwide health care issue and without understanding the causes of cancellations, it is difficult to devise an effective intervention to address this issue.
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Garnier F, Sciard D, Marchand-Maillet F, Theissen A, Mohamed D, Alberti C, Beaussier M. Clinical Interest and Economic Impact of Preoperative SMS Reminders before Ambulatory Surgery: A Propensity Score Analysis. J Med Syst 2018; 42:150. [PMID: 29968118 DOI: 10.1007/s10916-018-1000-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Patient contact by telephone the day before ambulatory surgery is considered as a best practice. The Short Message Service (SMS) could be a suitable alternative. The objective of this prospective study was to evaluate the interest of preoperative instruction (PI) reminders by SMS compared to telephone calls. This was a prospective single center before-and-after study. Patients scheduled in ambulatory surgery were included during 2 consecutive periods of 10 weeks. The "Call" group received a telephone call for preoperative instructions (PI) and the "SMS" group received an automated protocol SMS reminder. The primary endpoint was patient compliance with PI and time of convocation. The two populations were compared with a non-inferiority hypothesis and the impact of the contact modality on compliance with the PI was assessed using a propensity score. The analysis concerned 301 patients in the Call group and 298 in the SMS group. The absence of dysfunction was observed in 75% of patients in the SMS group compared with 61% in the Call group (Risk difference: 14% [95%CI: 7-21]). The use of SMS was associated with a significant improvement in compliance with the PI (Odds ratio: 1.90 [1.48-2.42]; p < 0.0001). Patient satisfaction was similar regardless of the method of PI reminders. The automation of preoperative SMS reminders is associated with a better respect of the PI compared to the conventional calling method. This PI reminder method satisfies the majority of patients and may have a favorable financial impact.
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Affiliation(s)
- Fanny Garnier
- Department of Anesthesiology and Intensive Care Medicine and the Ambulatory Surgery Unit, St-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, UPMC Univ, Paris 6, France
| | - Didier Sciard
- Ambulatory Surgical Unit and Department of Anesthesiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - Florence Marchand-Maillet
- Department of Anesthesiology and Intensive Care Medicine and the Ambulatory Surgery Unit, St-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, UPMC Univ, Paris 6, France
| | - Alexandre Theissen
- Department of Anesthesiology and Ambulatory Care Center, Princess Grace Hospital, Pasteur Avenue, Monaco Principality, Monaco
| | - Damir Mohamed
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, University Paris Diderot, Sorbonne Paris-Cité, CIC-EC 1426 and, UMR-S 1123 ECEVE, 75019, Paris, France
| | - Corinne Alberti
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, University Paris Diderot, Sorbonne Paris-Cité, CIC-EC 1426 and, UMR-S 1123 ECEVE, 75019, Paris, France
| | - Marc Beaussier
- Ambulatory Surgical Unit and Department of Anesthesiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
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Al Talalwah N, McIltrot KH. Cancellation of Surgeries: Integrative Review. J Perianesth Nurs 2018; 34:86-96. [PMID: 29678319 DOI: 10.1016/j.jopan.2017.09.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 08/19/2017] [Accepted: 09/22/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE To analyze cancellations of surgeries and identify evidence-based interventions to address this issue. DESIGN Integrative literature review. METHODS An integrative literature search was conducted in four databases: CINAHL, PubMed, Embase, and Cochrane and included literature sources dated January 2011 to January 2016. The complete list of search terms consisted of the following: ambulatory surgery, day surgery center, elective surgical procedure, elective operation, elective surgery, schedule, access to care, surgery cancellation, operation cancellation, and surgery delay. FINDINGS Twenty-three literature sources were identified. Evidence included one randomized controlled trial and multiple studies. Causes of cancellations were classified into three categories: hospital-related reasons, patient-related reasons, and surgeon-related reasons. Evidence confirmed most cancellations were avoidable. CONCLUSIONS Cancellation of scheduled surgeries has a significant impact on patients' health, resources, cost, and quality of care. It is difficult to devise a solution without understanding the cause of cancellations.
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Fergusson D, Monfaredi Z, Pussegoda K, Garritty C, Lyddiatt A, Shea B, Duffett L, Ghannad M, Montroy J, Murad MH, Pratt M, Rader T, Shorr R, Yazdi F. The prevalence of patient engagement in published trials: a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:17. [PMID: 29796308 PMCID: PMC5963039 DOI: 10.1186/s40900-018-0099-x] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/17/2018] [Indexed: 05/20/2023]
Abstract
PLAIN ENGLISH SUMMARY With the growing movement to engage patients in research, questions are being asked about who is engaging patients and how they are being engaged. Internationally, research groups are supporting and funding patient-oriented research studies that engage patients in the identification of research priorities and the design, conduct and uptake of research. As we move forward, we need to know what meaningful patient engagement looks like, how it benefits research and clinical practice, and what are the barriers to patient engagement?We conducted a review of the published literature looking for trials that report engaging patients in the research. We included both randomized controlled trials and non-randomized comparative trials. We looked at these trials for important study characteristics, including how patients were engaged, to better understand the practices used in trials. Importantly, we also discuss the number of trials reporting patient engagement practices relative to all published trials. We found that very few trials report any patient engagement activities even though it is widely supported by many major funding organizations. The findings of our work will advance patient-oriented research by showing how patients can be engaged and by stressing that patient engagement practices need to be better reported. BACKGROUND Patient-Oriented Research (POR) is research informed by patients and is centred on what is of importance to them. A fundamental component of POR is that patients are included as an integral part of the research process from conception to dissemination and implementation, and by extension, across the research continuum from basic research to pragmatic trials [J Comp Eff Res 2012, 1:181-94, JAMA 2012, 307:1587-8]. Since POR's inception, questions have been raised as to how best to achieve this goal.We conducted a systematic review of randomized controlled trials and non-randomized comparative trials that report engaging patients in their research. Our main goal was to describe the characteristics of published trials engaging patients in research, and to identify the extent of patient engagement activities reported in these trials. METHODS The MEDLINE®, EMBASE®, Cinahl, PsycINFO, Cochrane Methodology Registry, and Pubmed were searched from May 2011 to June 16th, 2016. Title, abstract and full text screening of all reports were conducted independently by two reviewers. Data were extracted from included trials by one reviewer and verified by a second. All trials that report patient engagement for the purposes of research were included. RESULTS Of the 9490 citations retrieved, 2777 were reviewed at full text, of which 23 trials were included. Out of the 23 trials, 17 were randomized control trials, and six were non-randomized comparative trials. The majority of these trials (83%, 19/23) originated in the United States and United Kingdom. The trials engaged a range of 2-24 patients/ community representatives per study. Engagement of children and minorities occurred in 13% (3/23) and 26% (6/23) of trials; respectively. Engagement was identified in the development of the research question, the selection of study outcomes, and the dissemination and implementation of results. CONCLUSIONS The prevalence of patient engagement in patient-oriented interventional research is very poor with 23 trials reporting activities engaging patients. Research dedicated to determining the best practice for meaningful engagement is still needed, but adequate reporting measures also need to be defined.
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Affiliation(s)
- Dean Fergusson
- Ottawa Hospital Research Institute, Ottawa, ON Canada
- Centre for Practice-Changing Research, Office L1298a, 501 Smyth Road, Box 201B, Ottawa, ON K1H 8L6 Canada
| | | | | | | | - Anne Lyddiatt
- Patient Partner SPOR National Steering Committee, Ottawa, ON Canada
| | - Beverley Shea
- Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Lisa Duffett
- Department of Hematology, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Mona Ghannad
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | | | - M. Hassan Murad
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN USA
| | - Misty Pratt
- Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Tamara Rader
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON Canada
| | | | - Fatemeh Yazdi
- Ottawa Hospital Research Institute, Ottawa, ON Canada
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Turunen E, Miettinen M, Setälä L, Vehviläinen-Julkunen K. The impact of a structured preoperative protocol on day of surgery cancellations. J Clin Nurs 2017; 27:288-305. [DOI: 10.1111/jocn.13896] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Elina Turunen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
- Kuopio University Hospital; Kuopio Finland
| | | | - Leena Setälä
- Hospital District of Southwest Finland; Turku Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
- Kuopio University Hospital; Kuopio Finland
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17
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Internet-Based Resources Frequently Provide Inaccurate and Out-of-Date Recommendations on Preoperative Fasting. Anesth Analg 2016; 123:1463-1468. [DOI: 10.1213/ane.0000000000001590] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hori Y, Nakayama A, Sakamoto A. Surgery cancellations after entering the operating room. JA Clin Rep 2016; 2:40. [PMID: 29492435 PMCID: PMC5813762 DOI: 10.1186/s40981-016-0066-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/18/2016] [Indexed: 11/25/2022] Open
Abstract
Background Surgery cancellation results in unavailability of the operating room and loss time. We identified the frequency of and reasons for operation cancellations after patients entered the operating room and assessed the preventability of such cancellations. Findings A retrospective chart review of all scheduled surgical procedures proposed under general anesthesia in a period spanning 2008 to 2016 was performed, and the reasons for cancellation were assessed. A total of 30 surgery procedures were cancelled after the patient had entered the operation room and preparation for general anesthesia had been completed. Ten of 18 cases (55.6%) that were cancelled before general anesthesia induction could have been prevented, accounting for 36.7% of the overall cancellations. The majority of the cancellations after anesthesia were due to the patients’ health status. Conclusions Improving the systems for checking patients’ medical problems and performing preoperative evaluations can reduce the number of cancellations after the patient has entered the operating room.
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Affiliation(s)
- Yoko Hori
- Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Ayami Nakayama
- Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Atsuhiro Sakamoto
- Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603 Japan
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