نوع مقاله: مقاله پژوهشی

نویسندگان

چکیده

مقدمه: لغو اعمال جراحی در آخرین لحظات یکی از مهم‌ترین عوامل در عدم کارایی و اتلاف منابع بیمارستان است و موجب ایجاد بی‌نظمی در اتاق عمل، اتلاف وقت، سرگردانی و بیکاری پرسنل و اشغال بی‌مورد تخت‌های بیمارستانی می‌شود. لذا در این پژوهش به مقایسه میزان و علل لغو اعمال جراحی در بیمارستان نمازی قبل و بعد از اجرای طرح تحول سلامت پرداخته شد.مواد و روش: مطالعه حاضر از نوع مقطعی بود که در بیمارستان نمازی شیراز انجام شد. مشخصات کلیه اعمال جراحی مورد نیاز از یک تیر 1392 لغایت پایان اسفند 1393به صورت سرشماری جمع‌آوری و در چک لیست محقق ساخته ثبت گردید. متغیرهای مورد بررسی شامل تعداد اعمال جراحی انجام شده در هر ماه، تعداد اعمال جراحی لغو شده در هر ماه و علل لغو اعمال جراحی بود. داده ها با استفاده از نرم افزار SPSS نسخه مورد تحلیل قرار گرفت.یافته‌ها: میزان اعمال جراحی بعد از طرح تحول سلامت افزایش و شاخص لغو اعمال جراحی از 73/11 درصد قبل از طرح تحول به 94/10 درصد بعد از طرح تحول کاهش یافت. قبل از طرح تحول سلامت بیشترین علت لغو اعمال جراحی، عوامل مربوط به جراح بود. بیشترین علت لغو اعمال جراحی بعد از تحول سلامت، دلایل سازمانی و مدیریتی بودکه در این میان، بیشترین مورد مربوط به کمبود وقت اتاق عمل بود.بحث و نتیجه­گیری: به نظر می­رسد انجام طرح تحول سلامت توانسته است به میزان زیادی لغو اعمال جراحی را کاهش دهد. ولی تلاش در راستای برنامه‌ریزی و مدیریت صحیح جهت رفع علل قابل پیشگیری و استفاده از حداکثر ظرفیت اتاق‌های عمل و بهبود فرایند اعمال جراحی، جهت ارتقای شاخص لغو اعمال جراحی ضروری به نظر می‌رسد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of Number of Surgical Operations and Their Cancellation Causes in Namazi Hospital before and after the Health Transformation Plan

نویسندگان [English]

  • Peyvand Bastani
  • Zohreh Rezaee
  • Zahra Kavosi
  • Mahdieh Sadat Ahmadzadeh

چکیده [English]

Background: Surgery cancellation at the last moments is one of the most important causes of inefficiency and waste of hospital resources, which results in operating room disorder, waste of time, wandering and unemployment of personnel, and useless occupation of hospital beds. Therefore, the present study aimed to compare the number of surgical operations and their cancellation causes before and after the healthcare reform.
Methods: The present cross-sectional study was conducted in Namazi hospital, Shiraz. The specifications of all the required surgeries were collected from June 22, 2014 to February 20, 2015 through census and were recorded in a researcher-made checklist. The study variables included the number of performed surgical operations per month, number of cancelled surgical operations per month, and their cancellation causes. The data were analyzed using the SPSS statistical software, version 20.
Results: The number of surgical operations was increased after the healthcare reform. Besides, the index of surgery cancellation was decreased from 11.73% to 10.94% after the reform. The most common causes of surgery cancellation before the healthcare reform were the factors related to surgeons. On the other hand, the most common causes of surgery cancellation after the healthcare reform were organizational and managerial factors, the most common of which being lack of time in operating rooms.
Conclusion: It seems that the reform has been able to reduce surgery cancellation rate to a great extent. Nevertheless, proper planning for elimination of the preventable causes, proper management for use of the maximum capacity of operating rooms, and improvement of surgical operation processes are essential in order to promote the surgery cancellation index.

کلیدواژه‌ها [English]

  • Selective surgical operation
  • Surgery cancellation
  • Healthcare reform

  1. Zare M, Amrollahi M. Check elective surgery cancellations in the teaching hospitals. Journal of Yazd University of Medical Sciences and Health Services 2009; 12(2):28-22 [Persian].
  2. Mastaneh Z, Mouseli L. Health information position in new reform of American health care system. Journal of Health Information Management 2011;8(1):97-101 [Persian].
  3. Davari M, Khorasani E, Bakhshizade Z, Jazi MJ, Darab MG, Maracy M. A single model for determining socioeconomic status in health studies; A crucial step to make the results more comparable. Value in Health 2014;7(17): 730.
  4. Ramezankhani Z, Markazi Moghaddam N, Haji Fathali A, Jafari H, Heidari M, Mohammadnia M. The rate and causes of surgery cancellation: identifying areas for improvement. Hospital Journal 2010; 1(3):27-34 [Persian].
  5. Kiasari A, Hassanzadeh F, Kabirzadeh D, MohseniSaravi B,  Bagherian A, Mirzaee Z. The prevalence of canceling surgical operations and related factors in hospital Imam Khomeini in Sari. Journal of Mazandaran University of Medical Sciences 2008;18(65):62-52.
  6. Asgari A, Haryalchi K, ZahiriSerori Z. Operation Cancellation in Elective Gynecologic and Urologic Surgeries in two Teaching Hospitals. Journal of Guilan University of Medical Sciences 2013; 22 (87):7-14.
  7. S, Mohta A, Gupta A,  Kamal G. Cancellation of elective cases in pediatric surgery: An audit. Journal of Indian Association Pediatrics Surgery 2010; 15(3): 90–92.
  8. Mahoori A, Noruzinia H, Seville S. The evaluation of performance in APEC to reduce the amount of canceled elective surgeries per day. Journal of Anesthesiology and Intensive Care 2008;2(63):1-10.
  9. Ahmadian L, Mirmohammadi M, Ghasemi S. Developing information content for the documentation of surgery cancellation reasons in Hospital Information System. Journal of Health and Biomedical Informatics 2014; 1(1): 45-53.
  10. Tait AR, Voepel-Lewis TMunro HM, Gutstein HBReynolds PI. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. Journal of Clinical Anesthesia 1997; 9(3): 213 – 219.
  11. Muhammad A, Mohammadi R, Sgrnzhad M. To investigate the causes of surgery cancellation Martyrs hospital in Kermanshah. Journal of Healthcare Management 2011;1(2):29-35 [Persian].
  12. Collection guidelines for health system reform plan. Health deputy: Iranian Ministry of Health and Medical Education; 2014. [database on the Internet: Accessible at: hppt:// darman.umsha.ac.ir/uploads] [Persian].
  13. Evaluation of health system development plan in the area of treatment. Iranian Ministry of Health and Medical Education, 2015. [database on the Internet: Accessible at: http://alef.ir/vdcdnf0xfyt0596.2a2y.html?271691] [Persian]
  14. Health reform plan in the evaluation of treatment. Journal of Taadol. Iranian Ministry of Health and Medical Education; 2015.
  15. The healthcare reform plan, Mobilize the medical community in Tehran, 2015. Accessible at: http://www.bmtehran.ir/newsview.aspx?id=747.
  16. Ministry of Health and Medical Education Development Bureau and physical resources, civil affairs. Standard secure hospital planning and design. Understanding the hospital 2015:47-52.
  17. Shetabi H, Karami B, Joybari T, Naseri H. Quantitative changes in resulting from the implementation of healthcare reform in a variety of surgical procedures performed in Imam Khomeini hospital in Kermanshah. International Conference on sustainable development in the health system. Isfahan University of Medical Sciences. Abstracts book. 2015:56.
  18. Zhijian L, Jiale H, Lin L, Shenglan T, and Jin M. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011. BMC Public Health 2012; 12(1): 9.
  19. Nanjappa N, Kabeer KK, Robinson S. Elective Surgical Case Cancellation–An Audit. International Journal of Current Research and Review 2014; 6(24): 19-23.‏
  20. Muhammad A, Mohammadi R, Sgrnzhad M. To investigate the causes of surgery cancellation Martyrs hospital in Kermanshah. Journal of Healthcare Management 2011;1(2):29-35. [Persian]
  21. Chang JH, Chen KW, Chen KB, Poon KS, Liu SK. Case review analysis of operating room decisions to cancel surgery.  BMC Surg 2014;14: 47.
  22. Rajender K, Ritika G. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital. Journal of Anaesthesiol Clinical Pharmacology 2012; 28(1): 66 – 69.
  23. Anna L, Chiu CH, Chui PT. Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: point prevalence and reasons. Hong Kong Medical Journal 2012; 18(1): 5-10.
  24. Cavalcante JB, Pagliuca LM, Almeida PC. Cancellation of scheduled surgery at a university hospital: an exploratory study. Revista latino-americana de enfermagem 2000; 8(4): 65 – 59.
  25. Aguirre –Cordova JF, Chaves-Vazquez G, Huitron-Aguilar GA, Cortes-Jimenez N. Why is surgery cancelled? Causes, implications and bibliographic antecedents. Journal of Gaceta Medica de Mexico 2003; 139(6): 545 – 551.
  26. Kolawole IK, Bolaji BO. Reasons for cancellation of elective surgery in Ilorin. The Nigerian Journal of Surgical Research 2002; 4(1): 28–33.
  27. Rakesh G, Bhalotra AR, Bhadoria P, Nishkarsh G, Raktima A. Reasons for cancellation of cases on the day of surgery–a prospective study. Indian Journal Anaesthesia 2009; 53(1): 35 – 39.
  28. Samson G, Arshad Z, Tariq S M, AhmedS, Ansari JA, Cancelled elective general surgical operations in Ayub teaching hospital.  Journal of Ayub Medical College Abbottabad 2007; 19(3): 64 – 66.
  29. William N Schofield, Cancellation of operations on the day ofintended surgery at a maro Australian referral hospital. Medical Journal of Australia 2005; 182(12): 612 – 615.
  30. Chalya PL,  Gilyoma JM,  Mabula JB, Simbila S,  Ngayomela IH,  Chandika AB, and et al. Incidence, causes and pattern of cancellation of Elective surgical operations in a University Teaching Hospital in the Lake Zone, Tanzania. Journal of African Health Sciences 2011; 11(3): 438 – 443.
  31. Jonnalagadda R, Walrond  ER, Hariharan S, Walrond M, Prasad C. Evaluation of the reasons for cancellations and delays of surgical procedures in a developing country, International Journal of Clinical Practice 2005; 59(6): 716 – 720.
  32. Gonzalez –Arevalo A, Gomez-Arnau JI, delaCruz FJ, Marzal JM, Ramírez S, Corral EM, and et al. Causes for cancellation of elective surgical procedures in a Spanish general hospital, Journal of Anaesthesia  2009; 64: 487 – 493.