The challenge of cancellations on the day of surgery

Dimitriadis, Panagiotis A.; Iyer, Srinivasan; Evgeniou, Evgenios

doi:10.1016/j.ijsu.2013.09.002

Cited by 81 publications

(102 citation statements)

References 15 publications

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“…According to a study by Dimitriadis et al, 3 the overall rate of same day elective surgery cancellation varied significantly, ranging from 5% to 40%. The researchers investigated the various reasons for same day surgery cancellations and proposed various examples of strategies to reduce them 3 . One of the examples they emphasized was the importance of a well‐established preassessment service and the patient's compliance with preoperative instructions.…”

Section: Setting and Problem Descriptionmentioning

confidence: 99%

Reducing Surgery Cancellations at a Pediatric Ambulatory Surgery Center

Lee¹,

Rodgers²,

Oh³

et al. 2017

AORN Journal

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Surgery cancellations are costly and can be frustrating for patients, their families, and the surgical team. Because of the inherent nature of an ambulatory surgery center, which only performs scheduled elective procedures, surgical cancellations typically result in wasted time and resources. Pediatric surgery cancellations can be mitigated with proper preoperative screening and communication between nurses and patients' guardians. To reduce the rate of cancellation at our pediatric ambulatory surgery center, we implemented a Nurse-Patient Preoperative Call Log. Preoperative nurses called patients or their guardians on two separate occasions during the two weeks before surgery to review health history and instructions and answer questions about the upcoming surgery. Three months after implementing the call log, surgery cancellation rates significantly decreased from 16.8% to 8.8% (P < .05). Nurses used the call log for all patients, with 85.6% of patients receiving two calls in the two weeks before their surgery.

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Section: Setting and Problem Descriptionmentioning

confidence: 99%

Reducing Surgery Cancellations at a Pediatric Ambulatory Surgery Center

Lee¹,

Rodgers²,

Oh³

et al. 2017

AORN Journal

View full text Add to dashboard Cite

show abstract

“…% of cancellations were due to medical reasons. 20 Chamisa et al had also explained that medical reasons contribute to 65.1% of cancellations. 21 Medical reasons contributing to cancellations were reported in other studies too.…”

Section: Sl No Scheduled Casesmentioning

confidence: 99%

Audit of Cancellation of Elective Surgeries in a Teaching Hospital in South India

Ganesan¹,

Anuradha²,

P³

2015

jemds

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BACKGROUND: Cancellation of scheduled surgical procedures is an issue of healthcare quality as well as a major cause of waste of health resources. This results in emotional trauma and inconvenience to the patients and their families. AIM: The objective of this audit was to find out the prevalence and causes of cancellation so that solutions can be made out to improve the quality of healthcare. SETTINGS AND DESIGN: It was an observational study carried out in 400 bedded Teaching hospital in South India. METHODS AND MATERIALS: Elective surgeries scheduled in 400 bedded teaching hospital were studied from June 2014 to January 2015. On the day of surgery, the completed surgeries that were scheduled and the list of cancellations with the reason for cancellation were entered in separate registers, by the anaesthesiologist. STATISTICAL ANALYSIS: These data were analysed using Epi info software version 7. RESULTS: 2067 patients were scheduled for surgeries out of which 269 got cancelled resulting in 13.01% cancellations. The most common cause of cancellation was lack of operating time which was 43.12% of cancelled cases. CONCLUSION: Most of the reasons for cancellation were avoidable by judicious scheduling of lists and careful planning by the team involved in surgeries. KEYWORDS: Cancellation, Elective surgeries, Reasons, Lack of operating time, Overscheduling of cases. INTRODUCTION:Surgery remains one of the main modalities of treatment for some diseases and it is a team work involving the surgeons, anaesthesiologists and paramedical staff requiring a lot of planning and preparation. All patients scheduled for surgery undergo pre anaesthetic checkup well before surgery. Last moment cancellations of scheduled surgeries are arguably an issue of health care quality as well as a major cause of waste of health resources. 1 The resulting prolonged hospitalization causes anxiety, frustration, anger, emotional involvement and inconvenience to patients and their families, 1 quite apart from increasing the cost in terms of working days lost and disruption to daily life. 1,2 The simplistic approach to solve the problem of late cancellations focuses on finding the reasons for these cancellations, and then to provide a solution for each cause individually, or collectively for all identified causes. The rates and causes of cancellations are diverse and differ from one hospital to another. 3 Between 10% and 40% of booked elective operations may be cancelled before surgery takes place. 1,2,3,4,5 The most common cause of cancellations was lack of theatre time (i.e. over-running operating lists). 2,3,4,6,7 The other reasons include cancellation due to patient factors, cancellation for poorly optimized medical conditions, or cancellations due to administrative reasons. 2,3,4,6,8 An operating list may over-run because of delayed starts, slow turnover, unanticipated surgical/ anaesthetic problems or staff shortages. 9 Many of these are difficult to quantify. This study was designed to find out the prevalence of and the reasons f...

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“…Surgery cancelation is 1 of the uncertain factors and occurs in many hospitals, the rate of which ranges from 0.84% to 30.3%. Shi et al indicate that possible surgery cancelations derived from data mining and nonelective surgeries should be considered during scheduling.…”

Section: Introductionmentioning

confidence: 99%

A random forest and simulation approach for scheduling operation rooms: Elective surgery cancelation in a Chinese hospital urology department

Luo

Feng

Zhao

et al. 2018

Health Planning & Management

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Many hospitals encounter surgery cancelations for various reasons. We present a methodology applying data mining and simulation to optimize operating room (OR) scheduling in a urology department in West China Hospital. To the best of our knowledge, this is 1 of the first efforts to seek an optimal schedule solution based on cancelation risk of elective surgeries as well as OR allocation between elective and nonelective surgeries. First, chi-square test and random forest prediction modeling were used to predict potential elective surgeries with high cancelation risk, and the factors, including surgeon, number of days since admission of patient, first surgery or not, etc., that influence elective surgery cancelation were identified. Second, a simulation technology was designed to compare 7 different scheduling strategies. The results demonstrated that for elective surgery, cancelation rate low surgery first outperformed the others and increased the productivity of the ORs from 72% to 83%, while for nonelective surgery performed in a separate OR, there was no improvement because the supply was greater than necessary at present. However, in total, the selected strategies led to 7% higher productivity.

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The challenge of cancellations on the day of surgery

Cited by 81 publications

References 15 publications

Reducing Surgery Cancellations at a Pediatric Ambulatory Surgery Center

Reducing Surgery Cancellations at a Pediatric Ambulatory Surgery Center

Audit of Cancellation of Elective Surgeries in a Teaching Hospital in South India

A random forest and simulation approach for scheduling operation rooms: Elective surgery cancelation in a Chinese hospital urology department

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