Complexities in quality

Oral presentations in the theme ‘complexities in quality’ are now available to watch. Leave a comment below to join the discussion.

"It was a real eye-opener": Shadowing patients at the end of life to improve their experience of care

Joanna Goodrich

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Patient and ophthalmic care provider perceptions of cataract surgery outcome: Findings from an exploratory qualitative study

Christalla Pithara

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A case of a hidden or misunderstood problem: How representative are national performance indicators for operation cancellations in English NHS?

Buddhika S. W. Samarasinghe

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Behind the veil of silence: understanding adverse outcomes of psychotherapy

Lavanya Thana

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I was very depressed to find out that the operation cancellation performance indicator is pathetic in England. The surgery cancellation is a substantial problem in our hospital and management do not want to talk about it! - nice to see some good study with nice findings. More than 1 in 10 patient cancellations is a big problem, and 6.5 million appear to be relatively low cost to me. We need to learn lessons from the pre-COVID era to avoid we do not make the same mistake in post-COVID period! COVID situation appears to add another layer of complications, and there are new complexities to deliver surgery without cancelling them….. You mention surgery cancellation as a multi-factorial problem – what do you exactly mean by this?

Thanks for the comments. Although most studies and reports highlighted that surgery cancellations are due to lack of beds, theatre time or patient unwell and many others - these tend to be initiated reasons leads to surgery cancellation. Rather than one reason driving these initiated reasons for cancellations, I consider these are combinations of factors driving the surgery cancellations. These initiated reasons are driven by various organisational (e.g. design and capacity and demand, resource availability and staffing issues) or people related (e.g. staff engagement, leadership and tea work).

That is an interesting take on the problem -- I guess how do you study this kind of "conundrum" in a messy hospital environment is the next question. I enjoyed your presentation and good luck with the work. I am glad someone is doing some work on this "conundrum".

Thank you for the comment and the question- I want to test “the water” by presenting face to face this at the conference. I have not written this to a journal article yet but hoping to complete this at some point in the future.

Until I look at this presentation, I was in the impression that NHS monitor surgery cancellation rates in England - Thank you for making all this clear. Most NHS boards, CCG and even CQC, use the wrong performance indicators to understand surgery cancellation. It is a significant worry that more than 1 in 10 patient get cancelled in England - imagine the waste and negative impact on the patients. COVID adds many new complications to Surgery cancellation. It will be beneficial to hear how to reduce surgery cancellation in COVID setting.

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