Ann Surg Treat Res.  2017 Aug;93(2):65-69. 10.4174/astr.2017.93.2.65.

Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement

Affiliations
  • 1Department of Cardiothoracic Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan.
  • 2Department of Orthopaedic Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan. ttstation86@yahoo.com
  • 3Department of General Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan.
  • 4Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan.
  • 5Department of Anesthesia and Critical Care, Faculty of Medicine, The University of Jordan, Amman, Jordan.

Abstract

PURPOSE
To report rates of and reasons for operation cancellation, and to prioritize areas of improvement.
METHODS
Retrospective data were extracted from the monthly reports of cancelled listed operations. Data on 14 theatres were collected by the office of quality assurance at Jordan University Hospital from August 2012 to April 2016. Rates and reasons for operation cancellation were investigated. A Pareto chart was constructed to identify the reasons of highest priority.
RESULTS
During the period of study, 6,431 cases (9.31%) were cancelled out of 69,066 listed cases. Patient no-shows accounted for 62.52% of cancellations. A Pareto analysis showed that around 80% of the known reasons for cancellation after admission were due to a lack of surgical theatre time (30%), incomplete preoperative assessment (21%), upper respiratory tract infection (19%), and high blood pressure (13%).
CONCLUSION
This study identified the most common reasons for operation cancellation at a teaching hospital. Potential avoidable root causes and recommended interventions were suggested accordingly. Future research, available resources, hospital policies, and strategic measures directed to tackle these reasons should take priority.

Keyword

Operation cancellation; Quality improvement

MeSH Terms

Hospitals, Teaching*
Hypertension
Jordan
No-Show Patients
Quality Improvement
Respiratory Tract Infections
Retrospective Studies

Figure

  • Fig. 1 Cancelation rate flow chart from August 2012 to April 2016. JUH, Jordan University Hospital.

  • Fig. 2 Pareto chart of operative cancellations by identified reasons after admission; URTI, upper respiratory tract infection.


Reference

1. Appavu ST, Al-Shekaili SM, Al-Sharif AM, Elawdy MM. The burden of surgical cancellations and no-shows: quality management study from a large regional hospital in Oman. Sultan Qaboos Univ Med J. 2016; 16:e298–e302.
2. Ezike H, Ajuzieogu V, Amucheazi A. Reasons for elective surgery cancellation in a referral hospital. Ann Med Health Sci Res. 2011; 1:197–202.
3. Dhafar KO, Ulmalki MA, Felemban MA, Mahfouz ME, Baljoon MJ, Gazzaz ZJ, et al. Cancellation of operations in Saudi Arabian hospitals: Frequency, reasons and suggestions for improvements. Pak J Med Sci. 2015; 31:1027–1032.
4. Garg R, Bhalotra AR, Bhadoria P, Gupta N, Anand R. Reasons for cancellation of cases on the day of surgery-a prospective study. Indian J Anaesth. 2009; 53:35–39.
5. Caesar U, Karlsson J, Olsson LE, Samuelsson K, Hansson-Olofsson E. Incidence and root causes of cancellations for elective orthopaedic procedures: a single center experience of 17,625 consecutive cases. Patient Saf Surg. 2014; 8:24.
6. Mesmar M, Shatnawi NJ, Faori I, Khader YS. Reasons for cancellation of elective operations at a major teaching referral hospital in Jordan. East Mediterr Health J. 2011; 17:651–655.
7. Al Khawalde M, Al Gudah F, Al Soud N, Al Hroot M. Cancellation of elective surgical procedures, a single royal medical services hospital experience. J Royal Med Serv. 2015; 22:52–56.
8. NSW Department of Health. Pre-Procedure Preparation Toolkit [Internet]. Sydney: NSW Department of Health;revised Nov 2012. cited 2016 Nov 15. Available from: http://www.health.nsw.gov.au/policies/gl/2007/GL2007_018.html.
9. Atherton H, Sawmynaden P, Meyer B, Car J. Email for the coordination of healthcare appointments and attendance reminders. Cochrane Database Syst Rev. 2012; (8):CD007981.
10. Macharia WM, Leon G, Rowe BH, Stephenson BJ, Haynes RB. An overview of interventions to improve compliance with appointment keeping for medical services. JAMA. 1992; 267:1813–1817.
11. Pandit JJ, Carey A. Estimating the duration of common elective operations: implications for operating list management. Anaesthesia. 2006; 61:768–776.
12. van Veen-Berkx E, van Dijk MV, Cornelisse DC, Kazemier G, Mokken FC. Scheduling anesthesia time reduces case cancellations and improves operating room workflow in a university hospital setting. J Am Coll Surg. 2016; 223:343–351.
13. Saha P, Pinjani A, Al-Shabibi N, Madari S, Ruston J, Magos A. Why we are wasting time in the operating theatre. Int J Health Plann Manage. 2009; 24:225–232.
14. Kaddoum R, Fadlallah R, Hitti E, El-Jardali F, El Eid G. Causes of cancellations on the day of surgery at a Tertiary Teaching Hospital. BMC Health Serv Res. 2016; 16:259.
15. Emanuel A, Macpherseon R. The anaesthetic pre-admission clinic is effective in minimising surgical cancellation rates. Anaesth Intensive Care. 2013; 41:90–94.
16. Hartle A, McCormack T, Carlisle J, Anderson S, Pichel A, Beckett N, et al. The measurement of adult blood pressure and management of hypertension before elective surgery: Joint Guidelines from the Association of Anaesthetists of Great Britain and Ireland and the British Hypertension Society. Anaesthesia. 2016; 71:326–337.
17. World Federation of Societies of Anaesthesiologists. Anaesthesia Tutorial of the Week; upper respiratory tract infection and paediatric anaesthesia [Internet]. London (UK): World Federation of Societies of Anaesthesiologists;c2012. cited 2016 Nov 5. Available from: http://www.wfsahq.org/resources/anaesthesiatutorial-of-the-week.
18. Sanjay P, Dodds A, Miller E, Arumugam PJ, Woodward A. Cancelled elective operations: an observational study from a district general hospital. J Health Organ Manag. 2007; 21:54–58.
19. Schofield WN, Rubin GL, Piza M, Lai YY, Sindhusake D, Fearnside MR, et al. Cancellation of operations on the day of intended surgery at a major Australian referral hospital. Med J Aust. 2005; 182:612–615.
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