Elective Surgical Cancellations in a Tertiary Hospital in the Middle East: Quality Improvement Process

Abstract

Purpose: Cancellation of elective surgery negatively affects patient outcomes and the efficiency of the work environment. The purpose of this project was to analyze the cancellation of elective surgeries and identify the best evidence-based interventions to address cancellations in a tertiary hospital in the Middle East.

Design: A quality improvement study design.

Methods: A retrospective review of cancellations conducted over two 3-month periods in 2016 and 2017.

Findings: In both phases of the audit, patient-related reasons were the leading cause of cancellations. Conducting a preoperative call 2 days before surgery and doing a weekly review of the surgery schedule reduced cancellations from 3.8% to 3.5%. Cancellations because of patient-related reasons reduced from 81% to 79.7% whereas cancellations because of hospital-related reasons reduced from 17.5% to 15.9%.

Conclusions: Cancellation of surgeries is a worldwide health care issue and without understanding the causes of cancellations, it is difficult to devise an effective intervention to address this issue.

Keywords: elective surgery; postanesthesia care unit; preoperative calls; quality improvement; surgery cancellations; surgery delay.