Hospital policy following cancelled orthopaedic surgery and the patient experience—making the best of a bad situation

Le résumé fourni par la source

Background: Number of cancelled elective orthopaedic surgeries has increased over the last decade as strains on surgical services exacerbates. Being told an operation is cancelled is disappointing for the patient, the clinician and is not without a financial loss. This experience is frustrating for patients who are often not informed of cancellations by doctors and sent home dissatisfied without clarity of treatment plans. Alternatives have to be sought to safeguard the patient experience, maintain communication and avoid wastage of resources. Methods: Over a 1-year period, 117 patients were prospectively shortlisted with a cancellation on the day of surgery in a dedicated elective orthopaedic unit. Questionnaire data assessed adherence to Association of Anaesthetists of Great Britain and Ireland Theatre Efficiency guidance, including: healthcare professional informing patients; time offered for explanation; patient understanding and satisfaction as well as perception of being kept nil by mouth (NBM) longer than necessary. Opinions of alternative satisfactory professionals to lead cancellation discussion was also evaluated. Results: 35.04% of cancellations were informed by consultants, 23.77% by junior doctors and 38.46% by nurses. Out of 10, patient understanding was 8.31 and satisfaction 6.37 for consultant led discussions against 5.12 and 4.07 for nurses, respectively. Overall, 35.04% of patients felt they were kept NBM longer than necessary vs. 60% of the 45 patients told by nurses. 90.60% felt consultants were the ideal professional to lead cancellation discussions however 70.94% stated a registrar would be satisfactory. Conclusions: Cancelled elective surgery that a patient has mentally prepared for is extremely demoralising. Poor peri-operative communication and management further worsens the patient experience and represents sub-standard care. It is paramount that guidelines exist where patients are informed of reasons for cancellation by a senior surgeon in a manner that accounts for availability of resources.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.