Monitoring the Suspension of Surgical Procedures

Abstract

Introduction: A surgical suspension generates a series of hassles and dissatisfaction of the patient and his family. Preparations for surgery involve an entire remodeling of the professional, social and family schedule, as well as other factors such as expectations regarding the results and the fear of the unknown. Objective: A quantification and identification of the reasons for surgical cancellations was realized for a better understanding and guidance to the leadership team's actions on this issue. Thus, their monitoring is important in the search for actions to make the surgery center´s processes more effective, favoring possibilities for improvement in the quality of hospital services. This way, the objective of this research was to identify the main causes for the cancellations of surgical procedures. Method: Study of documentary and retrospective type, quantitative, performed in the surgical center of a hospital in the city of Juazeiro do Norte, CE, Brazil. Data collection was performed through digital files of the 'syshosp' system used to record performed and suspended surgical procedures. Data were collected from January to December 2014 and analyzed using simplified statistics and presentation through a table. Results: The justifications for cancellation of procedures related to the organizational aspects of the institution were highlighted as main reasons for surgical suspension:  the priority for urgency, lack of material resources / equipment required for the surgical procedure and no hospitalization of surgical patients. There were also those related to the lack of staff, being most of them because of the surgeon's inability to attend and absence of anesthesiologist causing the impossibility of building the surgical team. Finally, the suspensions regarding priority for emergencies are highlighted. It was observed that the main determinants for surgical suspensions were those related to the organization of the hospital, with a total of 267 (51.1%), standing out among these: technical problems (16.1%), no admission (42, 3%), lack of material (13.5%) and the priority for urgency (21%). Discussion: The Brazilian Ministry of Health (Ministério da Saúde) defines the surgery suspension rate by the number of suspended surgeries divided by the total of scheduled surgeries in a given period and multiplied by 100³. During the studied period, there were 6591 scheduled surgeries 6069 surgeries were performed and there were 522 suspensions. Thus, the overall average rate of suspension obtained was 7.9%. Compared to other studies and the goals of the institution (5%), it is clear that this is a high rate, but manageable. Conclusion: It was observed that the suspensions of surgeries must be carefully monitored and analyzed by the entire team involved in order to disseminate this indicator and its possible consequences to all. The process of identification of consequences is still weak and needs to be strengthened to an effective action plan. It was revealed that the main cause of surgical cancellations during the surveyed year was related to the organization of the hospital, emphasizing the importance of updating the interaction of processes with the sectors that influence this indicator and preparation of strategic planning with everybody´s involvement so you can minimize the data, as it directly affect the patient, professionals and the hospital, resulting from the patient´s dissatisfaction to the longer permanency of the patient in hospital.