Abstract
BackgroundCase cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention.MethodWe conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors.ResultsCC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays.ConclusionsWorkup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.
Highlights
Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures
Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced cancellation rate (CR) among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations
It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday
Summary
Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. Operating Rooms (ORs) generate the highest costs in hospitals, while being the largest source of revenues [1]. As one of the leading causes that decrease the efficiency of ORs, case cancellation (CC) reduces utilization of OR time, affects surgeon productivity and staff morale, causes anxiety and emotional distress in patients, and results in extra costs for patients, physicians and hospitals [3–7]. It has been reported that the lost revenue from each cancelled case is $1430 to $1700 for hospitals not on a fixed annual budget in America [8, 9]. There has been growing interest to study CRs and CC reasons by researchers. Some studies have suggested that lack of available surgery resources was
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