The challenge of cancellations on the day of surgery

Introduction: Cancellations of planned surgical procedures have been a major and long-standing problem for healthcare organisations across the world. They represent a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for surgical trainees. The current study investigates the reasons for day of surgery cancellations at an NHS Foundation Trust in the United Kingdom and proposes strategies to reduce their incidence.

Methods: All cancellations of elective and emergency procedures during the period from January 2012 to December 2012 were identified retrospectively using the IQ Utopia patient management software.

Results: The rate of cancellations on the day of surgery for elective and planned emergency procedures during 2012 was 5.19%. The main reason for cancellation was patient not fit for operation (33.73%), followed by lack of beds (21.79%), lack of theatre time (17.31%), patient failed to attend (6.87%) and operation no longer necessary (4.08%).

Conclusions: Similar reasons for cancellations have been reported in studies from around the world. The published literature provides various examples of successful and unsuccessful strategies to reduce surgery cancellations, even when they are caused by factors that are sometimes considered unavoidable. The feasibility and profitability of approaches that have been proven to be successful in other institutions should be assessed thoroughly in the context of the individual institution's characteristics and individual problems before a decision for implementation is made.