Cancellation of operations on the day of intended surgery at a major Australian referral hospital.
OBJECTIVE
To establish the rate of and reasons for cancellations of surgery on the scheduled day in an Australian hospital.


METHODS
Prospective survey.


METHODS
Major metropolitan tertiary hospital, 13 May to 15 November 2002.


METHODS
Proportion of operations cancelled on the day of surgery, obtained each day from the operating theatre list and a separate list of additions and cancellations compiled on the day; reasons for cancellations from the cancellation list, extended or confirmed, as necessary, by questioning of bookings and ward staff, or members of the surgical team; estimated and actual duration of each operation and patient information from hospital clinical records.


RESULTS
7913 theatre sessions were scheduled by 133 surgeons in the study period; 941 of these (11.9%) were cancelled on the day, including 724 of 5472 (13.2%) elective procedures on working weekdays. Main reasons for cancellation were: no theatre time due to over-run of previous surgery (18.7%); no postoperative bed (18.1%); cancelled by patient (17.5%); and change in patient clinical status (17.1%). Procedural reasons (including patient not ready, no surgeon, list error, administrative cause, and communication failure) totalled 21.0%. Ear, nose and throat surgery experienced the most cancellations (19.6%), followed by cardiothoracic surgery (15.8%).


CONCLUSIONS
There were five major reasons of similar magnitude for on-the-day surgery cancellations. We estimated that 60% of cancellations of elective procedures were potentially avoidable. Change of one factor leading to cancellation (eg, provision of more postoperative beds) is not likely to lead to improvement unless the other major factors are also tackled.
Schofield
William N
WN
Centre for Health Services Research, University of Sydney at Westmead, Western Sydney Area Health Service, Hawkesbury Road, Westmead, NSW 2145, Australia. bills@cmed.wsahs.nsw.gov.au
Rubin
George L
GL
Piza
Michael
M
Lai
Ying Yin
YY
Sindhusake
Doungkamol
D
Fearnside
Michael R
MR
Klineberg
Peter L
PL
D001071:Appointments and Schedules; D001315:Australia; D001509:Bed Occupancy; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D009873:Operating Rooms / Q000706:statistics & numerical data; D011446:Prospective Studies; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*