Case cancellations on the day of surgery: an investigation in an Australian paediatric hospital.
BACKGROUND
This study investigates case cancellations on the intended day of surgery (DOS) at a paediatric hospital in Melbourne, Australia. The hospital in Melbourne treats over 32 000 inpatients annually and handles both elective and emergency cases.


METHODS
The data for this paper were collected over a period of 12 months, from June 2004 to June 2005. The data were extracted retrospectively from the theatre computer system. A nurse researcher reviewed the full written details of all cancellations to clarify their cause and confirm the reasons for cancellation; the reasons for cancellation were then sorted into one of 14 groups.


RESULTS
There were 16 559 theatre bookings, and of these, 1198 (7.2%) were cancelled on the DOS. There was a mean of 3.28 cancellations of surgery on the intended day. The hospital-initiated postponements accounted for 18.5% of DOS cancellations. The top four reasons for cancellation accounted for 65% of all cancelled surgeries and were all patient initiated.


CONCLUSIONS
There was also evidence that some specialties were more susceptible to DOS cancellation than others. The paper ends with proposals to reduce patient-initiated cancellations and directions for future research.
Haana
Victoria
V
Department of Management, University of Melbourne, Australia.
Sethuraman
Kannan
K
Stephens
Lisa
L
Rosen
Heather
H
Meara
John G
JG
D000293:Adolescent; D001071:Appointments and Schedules; D001315:Australia; D002648:Child; D017598:Efficiency, Organizational / Q000191:economics; D006776:Hospitals, Pediatric / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D009873:Operating Rooms / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics / Q000706:statistics & numerical data*; D013997:Time Factors; D014850:Waiting Lists