UNDERSTANDING THE VARIOUS CAUSES OF SURGERY START TIME DELAY: THE BEST APPROACH TO SOLUTIONS
Evaristus Chinonye Ezema*, Obioma Onah Ezema, Emmanuel Joachim Nebuwa, David Chibututu Nwobu, Ifeatu Ogochukwu Oranusi, George Chima Umeh, Chigozie Geoffrey Okafor, Chukwuemeka Chukwubuikem Okoro, Stanley Chigaemezu Egbogu and Princeston Chukwuemeka Okam
ABSTRACT
Background: Delay in operating room surgeries has impacted adversely on the patients, surgical teams, training system and the hospital revenue. Efficient utilization of the operating rooms involves prompt commencement of cases and undisrupted turnover. Our objective was to identify the causes of surgery start time delay and proffer possible solutions. Methodology: This was an observational study of all consecutive cases done over a 6-month interval, from October 2017 to March 2018. Using the hospital policy of starting surgery by 8.00 hrs, the delay was defined as starting surgery later than 8.00 hrs for the first case and interval between cases of more than 30 minutes. Reasons for delay in all cases were documented. The prevalence and causes were analyzed. P<0.05 was considered statistically significant. Results: 889 cases were analyzed, 798 (89.8%) of the cases were delayed. The mean delay time in all cases was 96.4 ±2.3 minutes. The nurse-related factor was the commonest (32.1%) cause of delay in surgery start time during the first case. In the subsequent cases, the hospital-related factor was the commonest (16.5%) cause of the delay. Late arrival of the surgeons constituted 78.7% cause of delay during the first case but in subsequent cases, non-optimization of patients’ comorbidity constituted 53.4 % of the delay. In the anaesthetist-related factor and patient-related factor, delayed availability of anaesthetic drugs and blood were the significant causes of delay respectively. Conclusion: The delays observed in this study were preventable. Genuine efforts by all concerned will invariably prevent these delays and improve theatre efficiency.
Keywords: Delay, factor, operating room, start time, surgery.
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