A new pathway for elective surgery to reduce cancellation rates.
Einar Hovlid1, Oddbjørn Bukve, Kjell Haug
1Institute of Social Science, Sogn og Fjordane University College, Sogndal, Norway. einar.hovlid@hisf.no
BMC Health Services Research
|June 13, 2012
Summary
Redesigning the elective surgery pathway significantly reduced cancellation rates from 8.5% to 4.9%. This improvement, sustained for 26 months, also increased the number of performed operations, optimizing resource use.
Area of Science:
- Healthcare Management
- Surgical Pathway Optimization
- Patient Flow Improvement
Background:
- High surgical cancellation rates lead to extended patient wait times, potential harm, and inefficient resource allocation.
- A Norwegian hospital redesigned its elective surgery pathway to mitigate these issues.
- Key changes included earlier patient assessment, enhanced planning systems, and greater patient involvement in scheduling.
Purpose of the Study:
- To evaluate the outcomes of a redesigned elective surgery pathway.
- To identify factors influencing the success of the pathway redesign.
Main Methods:
- Analysis of monthly planned, performed, and cancelled operations data.
- Statistical comparison of cancellation rates (CRs) before and after interventions using Student's t-test.
- U-chart analysis for sustained improvement and semi-structured interviews with hospital staff.
Main Results:
- The mean cancellation rate decreased from 8.5% to 4.9%, a statistically significant reduction sustained over 26 months.
- The median number of monthly operations performed increased by 17%.
- Factors contributing to success included a clear improvement strategy, clinician involvement, an electronic scheduling system, and middle manager engagement.
Conclusions:
- The redesigned clinical pathway effectively reduced surgical cancellations.
- The study demonstrated a sustained improvement in operational efficiency and patient throughput.
