Case review analysis of operating room decisions to cancel surgery

Ju-Hsin Chang,Shih-Kai Liu,Ke-Wei Chen,Kin-Shing Poon,Kuen-Bao Chen

doi:10.1186/1471-2482-14-47

Ju-Hsin Chang, Shih-Kai Liu + Show 3 more

Open Access

https://doi.org/10.1186/1471-2482-14-47

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Abstract

BackgroundCancellation of surgery close to scheduled time causes a waste of healthcare resources. The current study analyzes surgery cancellations occurring after the patient has been prepared for the operating room, in order to see whether improvements in the surgery planning process may reduce the number of cancellations.MethodsIn a retrospective chart review of operating room surgery cancellations during the period from 2006 to 2011, cancellations were divided into the following categories: inadequate NPO; medical; surgical; system; airway; incomplete evaluation. The relative use of these reasons in relation to patient age and surgical department was then evaluated.ResultsForty-one percent of cancellations were for other than medical reasons. Among these, 17.7% were due to incomplete evaluation, and 8.2% were due to family issues. Sixty seven percent of cancelled cases eventually received surgery. The relative use of individual reasons for cancellation varied with patient age and surgical department. The difference between cancellations before and after anesthesia was dependent on the causes of cancellation, but not age, sex, ASA status, or follow-up procedures required.ConclusionAlmost half of the cancellations were not due to medical reasons, and these cancellations could be reduced by better administrative and surgical planning and better communication with the patient and/or his family.

Highlights

Cancellation of surgery close to scheduled time causes a waste of healthcare resources
A total of 417 patients were included for evaluation and all patient records were collected from year 2006 to year 2011
For 31 patients (12.7%), the surgery was cancelled after general anesthesia had been induced

Summary

Introduction

Cancellation of surgery close to scheduled time causes a waste of healthcare resources. The current study analyzes surgery cancellations occurring after the patient has been prepared for the operating room, in order to see whether improvements in the surgery planning process may reduce the number of cancellations. Cancellations of surgical procedures can result in inefficient use of hospital resources and loss of hospital income. The most damaging cancellations with regard to inefficient and costly use of medical resources are cancellations that occur after the patient has been prepared for the operating room. Reasons for cancellations vary, depending on the patient population, the type of surgery, and the adequacy of hospital administrative procedures. In the pediatric population scheduled for day surgery, but not other populations, 35 to 40% of cancellations were reported to be due to upper respiratory infections [1,2].

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