Cancellations of scheduled surgical procedures in three Czech university hospitals - a prospective study
Abstract
Objective: Scheduled surgery cancellations are a significant problem in peri-operative medicine. They have a negative impact on every hospital economy and patient satisfaction with the quality of healthcare.
The goal of the study was to establish the rate and main reasons for elective surgery cancellations in three university hospitals in the Czech Republic in 2008. Design: Prospective, observational, multi-centre survey.
Setting: Anaesthesiology departments of tertiary care hospitals. Materials and methods: Every cancellation of an elective case under general or regional anaesthesia was recorded by the anaesthesiologist on a survey form.
The form included the detailed reason for the cancellation and the person initiating the cancellation (anaesthesiologist, surgeon, patient). The obtained data were analysed using the methods of descriptive statistics.
Results: In 2008, 66358 operations were scheduled as elective procedures in the three hospitals. In total 1248 cases (1.88%) were cancelled; 740 cases (59.3%) due to organizational reasons and 446 cases (35.7%) due to medical reasons.
Anaesthesiologists initiated the cancellation of 293 cases (23.5%), surgeons cancelled 873 operations (70%) and patients refused to undergo surgery or anaesthesia in 82 cases (6.5%). The mean age of patients whose procedure got cancelled was 52 years.
The results from the three hospitals were comparable. Conclusion:The number of cancelled elective cases was lower than in data from the literature.
However, most of the cancellations were potentially avoidable particularly with better operating suite management. The differences among the participating hospitals may be influenced by the different structure and capacity of the operating theatres and the method of scheduling elective operations.