Cancellations in ambulatory day surgery: Ten years observational study

Jiménez, Antonio José González; Artigas, C.; Elía, M.; Casamayor, C.; Gracia, J.A.; Martínez, Mariano

doi:10.1016/j.ambsur.2005.09.002

Cited by 25 publications

(31 citation statements)

References 10 publications

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“…It also enhances patient satisfaction and help boost staff morale [4]. As has been noted, cancellation rates vary with the size of the hospital facility as well as the surgical specialty; with urological cases, ENT and cardiothoracic surgeries noted to have high cancellation rates [9] [10] [17]. For elective urological surgeries the case cancellation rate was 20.8% at the public Tertiary Hospital (KBTH) compared to 17.1% at the privately managed health facility (TSH).…”

Section: Discussionmentioning

confidence: 99%

“…In the setting of a tertiary Teaching Hospital, high cancellations of elective surgeries also affect medical education, training and skills acquisition by Residents and other students in training. Elective surgical case cancellation rates as high as 13 % have been noted [8] and these rates vary with specialty with urology being one of the highest [9] [10]. The reasons for cancellation of elective surgical cases which may be patient-initiated or hospital-initiated are multifactorial [11] [12].…”

Section: Introductionmentioning

confidence: 99%

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Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Kyei¹,

Mensah²,

Bray³

et al. 2017

OJU

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Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies compared to private facilities in the same developing economy. Aims and Objectives: This comparative analysis was to determine the case cancellation rate and the reasons for cancellation of elective urological surgeries in a public tertiary hospital and a private specialist hospital in Accra. This is intended to form a basis for interventions aimed at reducing the case cancellation rate. Methods: This was a retrospective analysis of prospectively collected data on Day of Surgery cancelled elective urological cases from September 2014 to October 2015 at the urology unit of the Korle-Bu Teaching Hospital (KBTH), a public Tertiary Hospital and the Trust Specialist Hospital (TSH), a privately managed hospital in Accra. The reasons for case cancellation were categorized into structural factors, patient factors and process factors. Results: There was no significant difference between the case cancellation rate for elective urological cases at KBTH and the TSH which were 20.8% and 17.1% respectively (p = 0.317). For KBTH, the reasons for cancellation of elective urological cases were due to structural factors in 11/117 (9.4%), patient factors in 15/117 (12.8%) and process factors in 91/117 (77.8%) which was due mainly to surgery running late. At the TSH, the reasons were due to structural factors in 1/29 (3.4%), patient factors in 27/29 (93.1%) mainly due to patient not turning up and process factors in 1/29 (3.4%). Conclusion: The case cancellation rate of elective urological surgeries in both the Public Tertiary Hospital and the Private Specialist Hospital were high with no significant difference between the two. However, in the Public Tertiary Hospital, process factors predominated as the cause of these cancellations while patient factors were the predominant cause 23in the privately managed facility. Exposure of theater managers in public facilities to management practices in privately run facilities should be encouraged to help improve the efficiency of the public facilities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Kyei¹,

Mensah²,

Bray³

et al. 2017

OJU

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“…4,[17][18][19][20] In our experience, the available data allow some categorization of reasons for cancellations into patient-, structure-and process-related factors, differences of which were sensitive to variations over time as well as between surgical specialties. Our strategy of categorization is similar to those in other reports, 18,19 and it could be useful to identify potentially more modifiable reasons for cancellation. We found that in urology, 55% of cancellations were secondary to process-related causes.…”

Section: Discussionmentioning

confidence: 99%

“…3 Cancellation rates vary not only between different hospital types and sizes, 1 but also depends significantly on surgical leslie et al specialty and individual surgeons. 4,5,19,20 Comparatively high cancellation rates have been reported in specific services, such as urology and otolaryngology, [19][20][21] perhaps due to a bias of those with complex and variable case durations. 20 Given the documented increase in wait times in urology, 9 further investigation in a contemporary urological setting appears justified given the nature and scope of our specialty in an aging population.…”

Section: Introductionmentioning

confidence: 99%

“…14 Targeting interventions in focused areas, such as manipulation of case sequence or initiating preoperative evaluations closer to the OR date, 15,16 appear to be ineffective given the wide-ranging reasons for cancellations. Although it is reported that most cancellations may be avoidable, 4,6,[17][18][19] a consistent and standardized method of documenting contributing factors is lacking. Although reasons for cancellation are generally patient-or hospitalinitiated, 4,17 we have categorized these at our institution as structure-related (e.g., no hospital bed), patient-related (e.g., patient unwell) or process-related (e.g., scheduling error) based on Donabedian's quality of care framework.…”

Section: Introductionmentioning

confidence: 99%

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Day of surgery cancellation rates in urology: identification of modifiable factors

Leslie

Beiko

Vlymen

2013

CUAJ

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Objective: Day-of-surgery cancellations have a negative effect on operating room (OR) resources, as well as on patient satisfaction and perception of quality of care. Given increasing wait times in a universal healthcare system and the nature of urological surgery in our aging population, it should be a priority to identify modifiable risks of OR cancellations to assure timely and efficient delivery of care. We explore the rate and reasons for elective surgery cancellations in a Canadian urological practice. Methods: We evaluated the rate and reason of urological surgery cancellation at a single academic institution, prospectively collected in our centre's Operating Room Scheduling Office System (ORSOS) database. Documented reasons for cancellations were divided into 3 components: (1) structural factors (e.g., no hospital bed); (2) patient factors (e.g., patient unwell); and (3) process factors (e.g., scheduling error). Rates and reasons for cancellations were compared to those of General Surgery and Gynecology. The documented reasons for cancellation in the ORSOS database were confirmed or extended by chart review and interviews with a subset of cancelled patients. Results: Between 2005 and 2009, 1544 out of 19 141 (8.07 %) elective surgical cases were cancelled within the three surgical specialties (general surgery, gynecology and urology); urology had the highest average rate of 9.53%. Non-oncological cases represented a higher percentage of cancelled cases (15%, p < 0.001) and overall rates varied significantly over time in urology compared to the other surgical specialties. Potentially modifiable, processrelated causes were by far the most common reason for cancellation (58.5%) and "standby" cases were a common cause of overall cancellation rates. Patient interviews confirmed the emotional and financial impact of cancellation; there was no overwhelming concern that clinical outcomes were negatively affected. Conclusions: This contemporary exploration of cancelled urological cases is consistent with previous reports, although variable over time and dependent on definitions used. Potentially modifiable, process-related factors appear to be most frequently associated with cancellation, although more thorough and detailed documentation is required to further mitigate inefficient OR use. We suggest that all OR cancellations should be considered to be adverse incidents to be monitored by institutions in a systematic fashion.

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Same-Day Cancellation in Vascular Surgery: 10-Year Review at a Large Tertiary Care Center

Matzek

Smith

Mauermann

et al. 2020

Annals of Vascular Surgery

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Cancellations in ambulatory day surgery: Ten years observational study

Cited by 25 publications

References 10 publications

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Day of surgery cancellation rates in urology: identification of modifiable factors

Same-Day Cancellation in Vascular Surgery: 10-Year Review at a Large Tertiary Care Center

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