Methodology to reduce cancellations of scheduled
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abstract
ERDF – European Regional
Development Fund through the COMPETE Programme (operational programme for competitiveness) and
by National Funds through the FCT – Fundação para a Ciência e a Tecnologia (Portuguese Foundation for
Science and Technology) within project «FCOMP-01-0124-FEDER-037281».
Purpose - This study presents an integrated methodology to support the logistics
management in health facilities in waste reduction and elimination, by providing simple
and low cost solutions to minimize the cancellation of scheduled surgeries. The
methodology is applied in a Portuguese public hospital. This approach promotes and
improves the quality of services to patients.
Design/methodology/approach - The methodology is a problem-solving process which
could be applied to manage the flows of services (and materials), and associated
information, from the point of origin to the point of care. This approach integrates several
stages such as definition, measurement, analysis, improvement and control (DMAIC),
and uses the quality and management tools required to obtain efficient and effective
solutions to patients.
Findings - The enhanced methodology contributes to an understanding the origins of the
difficulties and waste. For the case study, the cancellation rate ranges from 19% and 21%
in 2011 and 2012, respectively, and increases to 29% in 2013, although, this year the
operating room performed the highest number of operations. The most critical root causes
of cancellations are related to the changing patient’s state of health, delays in previous
surgeries, scheduling of emergency operations, refusal to undergo surgery and other
causes.
Originality/value - One of the main contributions of this paper is to apply the DMAIC
based approach to study the cancellations of scheduled surgeries in a given Portuguese
public hospital, which is an issue rarely addressed in the literature.
