Abstract
Objectives: Day of surgery cancellations inconvenience patients and waste resources. Herein, we report the results of a one-year review of day of surgery cancellations. The primary outcome was percent same day cancellations. Secondary measures included avoidable versus unavoidable cancellations and patient versus hospital related cancellations. Patients and Methods: Cancelled cases were recorded in real time and then retrospectively reviewed. Monthly and at the end of the study period, the authors reviewed all day of surgery cancelled cases to confirm the reason for cancellation and to judge the event as avoidable or unavoidable. Results: 238/12176 (1.96%) were cancelled on the day of surgery. In six cases, no explanatory documentation could be found. Therefore, 232 cases were available for analysis. One-hundred nine cases were judged to be avoidable cancellations versus 123 that were judged unavoidable. Of the avoidable cancellations, 85% were hospital related versus 15% that were patient related causes. Of the avoidable, hospital related cancellations, the most common event were cases that were cancelled but not communicated. The greatest numbers of cancellations were deemed unavoidable and patient related. Conclusions: A cancellation rate of less than 2% is achievable. Advanced verification of complete surgical and medical evaluations may minimize this event.
Highlights
Day of surgery (DOS) cancellations can increase healthcare costs and significantly inconvenience patients and families. [1,2] Patients may suffer psychological stress and financial hardships, while hospitals may lose opportunities to perform surgery, waste disposable equipment opened for cases that are never performed, and expend resources in the form of salaries and benefits for workers who remain idle
232 cases were available for analysis
Of the elective surgery performed during the study period, 10% of the cases finished after 4 PM, and 6% of the elective cases finished after 5 PM
Summary
Day of surgery (DOS) cancellations can increase healthcare costs and significantly inconvenience patients and families. [1,2] Patients may suffer psychological stress and financial hardships, while hospitals may lose opportunities to perform surgery, waste disposable equipment opened for cases that are never performed, and expend resources in the form of salaries and benefits for workers who remain idle. Day of surgery (DOS) cancellations can increase healthcare costs and significantly inconvenience patients and families. Previous authors have reported DOS cancellation rates as high as 24%.[3,4,5,6,7,8,9] These findings were from a variety of practice settings, including international practices and government hospitals where surgical block time ends at a set time and cases that cannot be completed “in block” are rescheduled. In our integrated academic, physician led multi-specialty practice, the majority of surgical patients undergo evaluation in our preoperative medical evaluation (POE) clinic (a section of the anesthesiology department) or by their primary care provider. Our shared electronic medical record allows for convenient and timely communication between all physicians including anesthesiologists
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