Cancelled elective operations: an observational study from a district general hospital

Area of Science:

• Healthcare Management
• Surgical Operations
• Health Resource Optimization

Background:

• Cancelled elective operations represent a substantial drain on healthcare resources nationally.
• Approximately 8% of scheduled elective surgeries are cancelled within 24 hours of the procedure.

Purpose of the Study:

• To quantify the extent of operation cancellations within a specific National Health Service (NHS) Trust.
• To identify key reasons for cancellations and propose strategies for reduction.

Main Methods:

• A prospective survey was conducted over 12 months to track cancelled day case and in-patient elective operations.
• A dedicated nurse practitioner recorded cancellation reasons and timing relative to surgery.
• Cancellations were categorized into patient-related, hospital clinical, and hospital non-clinical reasons.

Main Results:

• Out of 13,455 operations, 1,916 (14%) were cancelled; 45% of these occurred within 24 hours of surgery.
• Patient-related reasons accounted for 51% of cancellations, followed by non-clinical hospital reasons (34%) and clinical reasons (15%).
• Common causes included inconvenient appointments (18.5%), list overruns (16%), patient unfitness perception (12.2%), and emergencies/trauma (9.4%).

Conclusions:

• A significant 14% of elective operations are cancelled, with nearly half within 24 hours of the scheduled time.
• Addressing patient-related and hospital non-clinical causes through targeted resources can substantially reduce cancellation rates.
• The study highlights the need for interventions focused on patient factors and hospital administrative/logistical issues to improve elective surgery scheduling efficiency.