Abstract
BACKGROUND: The delay in the starting of first elective surgical cases frequently occurs in the operation theatre. Its magnitude ranges from 24.8 to 99.3% and is contributed by many factors and it has the potential to induce major effects on the efficiency of the healthcare system. OBJECTIVE: To assess the magnitude and factors of delayed incision time of first cases among elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, 2022/23. METHOD: A hospital-based cross-sectional study was conducted on 421 elective surgical first-cases in Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, from January to April 28, 2023. The primary outcome of this study was the magnitude of delayed first cases' incision time of surgical patients. The data were collected using a structured questionnaire and systematic sampling method. Data was analyzed using statistical software for social sciences version 26. A chi-square test and logistic regression analysis were used for data analysis. Binary and multivariable logistic regression analysis was computed to determine the association between the independent and dependent variables. Independent variables with P < 0.20 were selected for multivariable analysis. Variables with P < 0.05 in a 95% confidence interval after multivariate analysis were selected as statistically significant. RESULTS: a total of 924 cases were scheduled as the first cases in the study period and 422 cases were recruited. The magnitude of delayed first-case incision time was 56.5% with a mean delayance of 33 min. A multivariate analysis identified a lack of anesthesia and/or adjuvant drugs [AOR = 2.65(1.14-6.16), P < 0.05], late anesthesia induction [AOR = 19.65(10.07-38.34), P < 0.01], surgeons' or residents' late arrival to the operation theatre [AOR = 2.37(1.1-5.14), P < 0.05], surgical positions other than supine [AOR = 2.47(1.23-4.97), P < 0.05] and type of surgery as a significant predictors of delayed first case start of elective surgeries. CONCLUSION AND RECOMMENDATION: The magnitude of delayed first cases' incision time among elective surgery was high (56.5%) with a mean time of delayance of 33 min. Lack of anesthetics or adjuvants, late anesthesia induction, late arrival of the surgical team, surgical position other than supine, and surgery types were significantly associated factors. It is recommended to develop an improvement plan to minimize first-case incision time delayance and improve surgical efficiency among elective surgeries.