In 2010, Pennsylvania ambulatory surgical facilities (ASFs) reported 3,648 events to the Pennsylvania Patient Safety Authority; 66% (n = 2,403) of these events were reported as “Incidents” and 34% (n = 1,245) of these events were reported as “Serious Events.” Of the reported serious events, 34% (n = 423 out of 1,245) indicated that the patient was transferred from the ASF to an acute care hospital. ASFs also reported 335 cancellations of procedures on the day of surgery.
The Authority initiated a regional ASF collaboration to examine presurgical screening and assessment processes and the frequency of ASF transfers and cancellations. Observations from during the collaboration include those below.
Figure. Transfer Rates: Participating Pennsylvania Ambulatory Surgical Facilities and National Ambulatory Surgical Center Quality Collaboration Facilities
Excerpted from: Gardner LA, Bomboy J. Preoperative screening and the influence on cancellations and transfers: an ambulatory surgical facility collaboration. 2014 Mar. http://patientsafety.pa.gov/ADVISORIES/Pages/201403_15.aspx
|Reason for Cancellation||No. of |
|% of |
|Change in medical status*||237 ||28.8|
|Preoperative instructions not followed||103||12.5|
|Procedure not rescheduled||77||9.3|
|Work related ||4||0.5|
|Language barrier||2||0.2 |
|* These cancellation reasons collected during the collaboration are rarely amenable to a nurse-driven preoperative screening and assessment. |
Excerpted from: Gardner LA. Tracking ambulatory surgical facility cancellations and transfers: lessons learned from an 18-month collaboration. 2014 Sep. http://patientsafety.pa.gov/ADVISORIES/Pages/201409_109.aspx