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      Cancelaciones de cirugías electivas en un hospital escuela: causas y estadísticas Translated title: Cancellations of elective surgeries in a teaching hospital: causes and statistics Translated title: Cancelamento de cirurgias eletivas em hospital escola: causas e estatísticas

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          Abstract

          RESUMEN: Objetivo: Investigar las tasas de suspensión y motivos de cancelación de las cirugías electivas en un hospital en Rio Grande do Norte. Métodos: Estudio descriptivo, retrospectivo, cuantitativo, con análisis documental de los registros archivados en el sistema informatizado MV de la unidad del Centro quirúrgico del Hospital Universitario Onofre Lopes, en el período de abril de 2015 a abril de 2016. Resultados: De las 8.622 (100%) cirugías programadas para el período investigado, el 74,2% fueron realizadas y el 25,8% canceladas. Entre las cirugías canceladas (2.227), la mayoría de las cancelaciones se hicieron por cirugía general (37,5%) y urología (21,6%). Los principales motivos de cancelación se introdujeron en las categorías relacionadas con la organización de la unidad (34,4%); relacionados con recursos humanos (27,1%); relacionados al paciente (6,5%); relacionado con materiales y equipamientos (6,2%), sin justificación (5,5%) y cirugía condicional (0,3%). Conclusiones: Este estudio se torna relevante, pues permitió identificar las causas de cancelaciones de cirugías electivas en un hospital de la red pública, contribuyendo para mejorar la actuación profesional frente a la problemática, siendo posible reducir la cantidad de suspensiones, considerando que la mayoría de los motivos de cancelación son prevenibles.

          Translated abstract

          ABSTRACT: Objective: To investigate the suspension rates and reasons for cancellation of elective surgery in a teaching hospital in Rio Grande do Norte. Methods: A descriptive, retrospective, quantitative study, with documentary analysis of the records filed in the computerized system of the Surgical Center unit of Onofre Lopes University Hospital, from April 2015 to April 2016. Results: Of the 8.622 (100%) scheduled surgeries for the surveyed period, 74.2% were performed and 25.8% canceled. Among the canceled surgeries (2.227), most cancellations were made by General Surgery (37.5%) and Urology (21.6%). The main reasons for cancellations were included in the categories related to the following aspects: unit's organization (34.4%); related to human resources (27.1%); patient-related (6.5%); related to materials and equipment (6.2%), without justification (5.5%) and conditional surgery (0.3%). Conclusions: The study identified the cancellations causes of elective surgeries in a teaching hospital, contributing to the improvement of professional performance. This may contribute to reduce the number of suspensions, considering that most reasons for cancellation are prevenTable.

          Translated abstract

          RESUMO: Objetivo: Investigar as taxas de suspensão e motivos de cancelamento de cirurgias eletivas em um hospital escola do Rio Grande do Norte. Métodos: Estudo descritivo, retrospectivo, quantitativo, com análise documental dos registros arquivados no sistema informatizado da unidade do Centro Cirúrgico do Hospital Universitário Onofre Lopes, no período de abril de 2015 a abril de 2016. Resultados: Das 8.622 (100%) cirurgias programadas para o período pesquisado, 74,2% foram realizadas e 25,8% canceladas. Dentre as cirurgias canceladas (2.227), a maioria dos cancelamentos foram feitos pela cirurgia geral (37,5%) e urologia (21,6%). Os principais motivos de cancelamentos foram inseridos nas categorias relacionados à organização da unidade (34,4%); relacionados a recursos humanos (27,1%); relacionados ao paciente (6,5%); relacionado a materiais e equipamentos (6,2%), sem justificativa (5,5%) e cirurgia condicional (0,3%). Conclusões O estudo permitiu identificar as causas de cancelamentos de cirurgias eletivas em um hospital escola, contribuindo para melhoria da atuação profissional frente a problemática, sendo possível reduzir a quantidade de suspensões, considerando que a maioria dos motivos de cancelamento são preveníeis.

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          The challenge of cancellations on the day of surgery.

          Cancellations of planned surgical procedures have been a major and long-standing problem for healthcare organisations across the world. They represent a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for surgical trainees. The current study investigates the reasons for day of surgery cancellations at an NHS Foundation Trust in the United Kingdom and proposes strategies to reduce their incidence.
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            The effect of hospital size and surgical service on case cancellation in elective surgery: results from a prospective multicenter study.

            Short-term case cancellation causes frustration for anesthesiologists, surgeons, and patients and leads to suboptimal use of operating room (OR) resources. In many facilities, >10% of all cases are cancelled on the day of surgery, thereby causing major problems for OR management and anesthesia departments. The effect of hospital type and service type on case cancellation rate is unclear. In 25 hospitals of different types (university hospitals, large community hospitals, and mid- to small-size community hospitals) we studied all elective surgical cases of the following subspecialties over a period of 2 weeks: general surgery, trauma/orthopedics, urology, and gynecology. Case cancellation was defined as any patient who had been scheduled to be operated on the next day, but cancelled after the finalization of the OR plan on the day before surgery. A list of possible cancellation reasons was provided for standardized documentation. A total of 6009 anesthesia cases of 82 different anesthesia services were recorded during the study period. Services in university hospitals had cancellation rates 2.23 (95% confidence interval [CI] = 1.49 to 3.34) times higher than mid- to small-size community hospitals 12.4% (95% CI = 11.0% to 13.8%) versus 5.0% (95% CI = 4.0% to 6.2%). Of the surgical services, general surgical services had a significantly (1.78, 95% CI = 1.25 to 2.53) higher cancellation rate than did gynecology services-11.0% (95% CI = 9.7% to 12.5%) versus 6.6% (95% CI = 5.1% to 8.4%). When benchmarking cancellation rates among hospitals, comparisons should control for academic institutions having higher incidences of case cancellation than nonacademic hospitals and general surgery services having higher incidences than other services.
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              COMUNICAÇÃO EFETIVA NO TRABALHO EM EQUIPE EM SAÚDE: DESAFIO PARA A SEGURANÇA DO PACIENTE

              RESUMO Ensaio reflexivo que versa sobre a comunicação efetiva na perspectiva do trabalho da equipe interdisciplinar para a qualidade dos cuidados em saúde e a segurança do paciente. Na análise do objeto em tela, identificou-se que programas de treinamentos de habilidades de comunicação, simulações práticas e maneiras padronizadas para apresentar informações do paciente constituem formas efetivas para transpor barreiras à comunicação ineficaz. A adoção de estratégias para melhoria da comunicação da equipe representa desafio que requer mudança na cultura de segurança do paciente nas organizações de saúde.
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                Author and article information

                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                2020
                : 19
                : 59
                : 286-321
                Affiliations
                [2] orgnameUniversidad Federal de Rio Grande do Norte Brasil
                [3] orgnameUniversidad Federal de Rio Grande do Norte Brasil
                [4] orgnameUniversidad Federal de Rio Grande do Norte Brasil gabrielasmm@ 123456hotmail.com
                [1] orgnameUniversidad Federal de Rio Grande do Norte Brasil
                Article
                S1695-61412020000300286 S1695-6141(20)01905900286
                10.6018/eglobal.396911
                2447dfb6-b230-4b14-b476-db68af4c223f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 09 November 2019
                : 24 September 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 36
                Product

                SciELO Spain

                Categories
                Originales

                Centro cirúrgico hospitalar,Hospital surgical center,Procedimientos quirúrgicos electivos,Procedimentos cirúrgicos eletivos,suspensões,Surgical specialties,Especialidades quirúrgicas,Especialidades cirúrgicas,Surgery cancellation,Elective surgical procedures,Centro quirúrgico hospitalario,suspensiones

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