BACKGROUND: Delay in scheduled surgeries in the operating room reflects negatively on the efficiency and the working environment. Moreover, post anesthesia care presents many unique challenges for anesthesiologists. Many hospitals have difficulty in discharging patients from the PACU due to several factors.3 The aim of this study was to evaluate the factors that cause delay in the start of surgery and prolonged stay in the post anesthesia care unit in order to recommend concrete measures to improve weaknesses in the system.
METHODS: This descriptive study was conducted at the Operating Room (OR) of Cardinal Santos Medical Center (CSMC) from January 1 to June 30, 2014. It included patients who underwent surgical procedures at the operating room of CSMC under anesthesia (i.e. general anesthesia, regional anesthesia, intravenous sedation) who were also admitted into the post anesthesia care unit. Time of induction of anesthesia and start and end time of surgery were obtained from the anesthesia records. Reports from the anesthesiology residents regarding reasons for delay were gathered. The duration of PACU stay and the reason for delay were recorded.
RESULTS: The most common cause of delay of surgery was shown to be late personnel (54.2%), followed by unavailability of equipment/room (30.5%). The least is billing clearance (5.2%). On the other hand, the most common cause of prolonged PACU stay was shown to be personnel (43.3%), followed by patient's recovery status (38.3%). The least is billing clearance (5%).
CONCLUSION: Timeliness of procedures at the OR and PACU stay are two of many factors which reflect efficiency of the operating room. This study showed that personnel is the leading cause of delay in both surgery and PACU stay. Policies must be modified, reminders must be given and communication among personnel must be made frequent in order to improve the system and restore the optimal flow of schedule.