Reducing Surgery Scheduling Errors

Donna Sue Watson

Surgery scheduling errors (SSE) are a recognized risk factor shown to contribute to wrong site surgery (WSS). Yet, research evidence related to SSE is lacking. The purpose of this dissertation study was to assess whether bundled team training interventions (BTTI) for surgeons and office staff could effectively improve the accuracy of surgery scheduling, therefore minimizing scheduling factors that may contribute to occurrence of WSS. The current study aimed to 1) Describe and compare SSE incidence rate and type before and after implementation of BTTI for surgeons and multidisciplinary staff and 2) Evaluate the trend of SSE before and after implementation of BTTI. SSE were captured February 16 through December 18, 2015 from a Regional Surgery Scheduling Department, serving eight hospitals and a same day surgery center the Puget Sound region of the Pacific Northwest. An interrupted time series design was implemented; each pre- and post-intervention segment consisted of 16 weekly data points. The BTTI included disclosure of pre-intervention scheduling errors, a scheduling verification checklist, updated surgery scheduling policy and procedure, and a toolkit to improve office scheduling. During the time period of this study, significant improvement in SSE were observed, with a decreased surgery SSE rate from 0.51% to 0.13% (p < 0.002). Reductions were observed in all SSE types. The segmented linear trend demonstrated the rate of SSE decreased over time (p < 0.001). Following the introduction of the BTTI, a slight decrease in the rate of SSE was observed (-0.002), however not statistically significant (p = 0.72). In the post-intervention segment no significant change in the linear trend was observed (p = 0.11). In the research literature, the reported incidence for SSE is 0.41% to 5.3%. Although rare, SSE are high risk with regard to potential patient safety implications for WSS. This study confirms the need for additional research targeted at understanding why SSE occur at the time of scheduling; associated economic cost for correcting an error; exploration and definition of best practices; tool development; and opportunities for patient involvement from the inception of the surgery scheduling decision.

Reducing Surgery Scheduling Errors

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