Obtaining day-of-surgery written surgical consent is associated with first-case delay

Abstract

Objective:

To assess the relationship between consent signature timing and first-start case delay.

Study Design:

Consecutive first start patients who arrived on day-of-surgery from home at a single centre from 28 days in June 2021 were identified. First-case delay was defined as operating theatre (OT) in-room time greater than 5 minutes after scheduled start time.

Results:

A total of 289 patients were eligible for the study. Surgical consent signing in the preoperative area and non-English primary language were significantly associated with OT delay; 234 patients (81%) had signed surgical consent on the day of surgery in the preoperative area. Patients who signed surgical consent on day- of- surgery were 3.2 times as likely to experience OT in-room time delay compared to those who signed surgical consent prior to day of surgery, odds ratio (OR) 3.2, 95% confidence interval (CI): 1.2, 8.5, p = 0.02. Patients with non-English primary language had 3.8 times greater risk for case delay (OR 3.8, 95% CI: 2.0, 7.4, p < 0.0001).

Conclusion:

Same day consent signing among patients arriving for surgery from home may cause significant operating theatre start time delays. In addition to ethical reasons, obtaining consent in the preoperative area should be avoided to improve preoperative efficiency.