How often does the operating list follow the planned order? An analysis of elective maxillofacial operating lists.
OBJECTIVE
The authors explored consistency of the observed running order in operating sequence compared with prior scheduled listing. We analysed potential variables felt to be predictive in the chances of a patient having their procedure as previously scheduled.


METHODS
Data were retrospectively collected for a consecutive group of patients who underwent elective maxillofacial procedures over a four week period. The consistency of scheduled and observed running order was documented. We considered four independent variables (original list position, day of week, morning or afternoon list, seniority of surgeon) and analysed their relationship to the probability of a patient undergoing their operation as per listing. Logistic regression analysis was used to determine significant associations between predictor variables with an altered list order.


RESULTS
Data were available for 35 lists (n = 133). 49% of lists were found to run according to prior given order, the remainder subject to some alteration. Logistic regression analysis showed a statistically significant association between original scheduled position and day of week, with list position consistency. Patients listed first were twelve times more likely to have their operation as listed compared to those placed fourth (OR 12.7, 95% CI 3.7-43, p < 0.05). Operating lists at the start of a week were subject to less alteration (p < 0.05). There was no demonstrated relationship between the grade of surgeon operating and alteration in operating sequence.


CONCLUSIONS
Approximately half of lists showed some alteration to the previously printed order. It appears that being first on an elective list offers the greatest guarantee that a patient will have their operation as per prior schedule. It may be reasonable for clinicians to be mindful of potential operating list alterations when preparing their patients for elective surgery.
The Department of Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, East Midlands, UK. Electronic address: drshafiqislam@hotmail.co.uk.
Shofiq
S
Islam
Wessex Deanery, Southern House, Otterbourne, Hampshire, UK.
Christopher J
CJ
Taylor
The Department of Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, East Midlands, UK.
Siddiq
S
Ahmed
The Department of Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, East Midlands, UK.
Ian W
IW
Ormiston
The Department of Maxillofacial Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, East Midlands, UK.
Jonathan P
JP
Hayter
D001071:Appointments and Schedules; D017598:Efficiency, Organizational / Q000592:standards*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration*; D012189:Retrospective Studies; D013515:Surgery, Oral / Q000458:organization & administration*; D013997:Time Factors; D006113:United Kingdom; D014850:Waiting Lists; D016526:Workload / Q000706:statistics & numerical data
Alteration; Day of week; Elective surgery; List position; Maxillofacial surgery; Observed order; Operating list