Obstetric Anaesthesia Annual Scientific Meeting 2023

Audit on the day of surgery cancellations of elective cesarean section at

Peterborough City Hospital (Cambridgeshire)

Dr Sethu Veerabadran, Dr Palani Prabhavathy, Dr Kelly McDonnell, Dr Shiny Sivanandan

Reasoning:

To study the reasons for on the day cancellations on the elective LSCS list, which leads to patient dis-satisfaction and negative theatre efficiency. We retrospectively collected data from 1/3/22 to 31/5/22. Details of total cases scheduled, operated, patients cancelled on day of surgery and reasons for cancellation were collected.

Results: Cancellation reasons were identified as

•1. Surgery not needed 44% - {VBAC, delivered, Induction, patient declined},

•2. Emergency LSCS 16%

•3. No midwife 11%

•4. No cot 6%

•5. Patient got covid 6%

•6. Surgery in other hospital each 6%

Audit Standards included:

Anaesthesia Clinical Services Accreditation standards 4.1.1.1

Anaesthesia Clinical Services Accreditation standards 1.7.2.5

RCOA Audit Recipe- Theatre use and Efficiency Pg 338

Efficiency, (ε) is best defined as the achievement of as near full use as possible without overrun or cancellation

Recommendations:

Based on the findings the following were recommended.

•there should be a dedicated mid-wife for the list who will liaise with patient to reconfirm their wishes and update the elective list based on it 12 hours prior to start time.

•If NICU bed could be delayed, that patient to be operated last so that baby can stay in theatre resuscitaire for longer.

To use probabilistic scheduling.

Changes implemented:

•Two more theatre sessions for elective LSCS per month introduced

•Dedicated midwife to follow-up on patients

Obstetric Anaesthesia Annual Scientific Meeting 2023

Audit on On the day of surgery cancellations of elective cesarean section at Peterborough city hospital.

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