Development of a Guideline for Preparing Patients to Reduce the Postponement of Surgery in Sisaket Hospital

Abstract

This objective of this study was to develop a guideline for the preparation of pre-operation patients in order to reduce the incidents of surgical suspension and postponement of cases due to unreadiness of the patients’ conditions for the surgery. It was a research and development study conducted in Sisaket Hospital comprising of 5 steps: (1) analysing the problems and the situation associated with the preoperative management and the postponement of cases, (2) developing a draft guideline for patient preparation, (3) initial testing and improving the guideline, (4) implementing the guideline in the hospital, and (5) evaluating the outcomes of the guideline implementation. The study participants were surgical patients requiring anesthetic care in in the fiscal year 2019 and the hospital’s multidisciplinary team (30 of them, including surgeons, patient ward nurses, anesthesiologists, anesthetic nurses, and medical technologists). The study tools were (1) the form specifying roles and duty of each category of the multidisciplinary team members, (2) patient record form for collecting data on age, ender, type of operation, ASA class, treatment unit, and the reasons for postponement of surgery, and (3) the report on the details of postponement of cases in accordance with the healthcare risk management system, Sisaket Hospital. It was foun that all members of the multidisciplinary team had utilized and followed the guideline. The incidence of postponement reduced from 0.2 percent in 20a8 to 0.1 percent in 2019. The guideline was found to be useful in improving the quality of surgical services and reducing the proponement of surgery; and it should be widely used for the management of care in hospitals providing surgical services.