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Same-Day Cancellation in Vascular Surgery: 10-Year Review at a Large Tertiary Care Center
Luke J Matzek1, Bradford B Smith1, William J Mauermann1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Insights
Same-day vascular surgery cancellations are infrequent (2%), often due to medical reasons. Focusing on foreseeable cancellations can improve patient care and reduce future events.
Area of Science:
- Vascular Surgery
- Healthcare Management
- Patient Safety
Background:
- Same-day cancellations of vascular surgical procedures negatively impact patient care.
- Multiple factors contribute to these cancellations, including medical issues, patient-related factors, and administrative problems.
Purpose of the Study:
- To analyze the incidence, reasons, and outcomes of same-day cancellations for vascular surgical procedures.
- To identify areas for improvement in scheduling and patient management to reduce cancellations.
Main Methods:
- Retrospective review of medical records from a large tertiary academic referral center (2007-2017).
- Identification of patients scheduled for vascular surgery who experienced same-day cancellations.
Main Results:
- 2% (361/17,887) of scheduled vascular procedures were cancelled on the same day.
- Medical reasons (55%) were the most common cause, followed by patient-initiated cancellations (12%) and administrative issues (10%).
- 7.3% of patients died within 30 days of their cancelled procedure; 69% eventually had the surgery.
Conclusions:
- Same-day vascular surgery cancellations are infrequent but have significant implications.
- While most cancellations are unforeseeable, addressing foreseeable reasons can enhance patient satisfaction and care.
- Strategies focusing on preventable cancellations are recommended to optimize vascular surgery scheduling and outcomes.
Background:
Same-day cancellation of vascular surgical procedures is an undesirable occurrence with multifaceted implications into the patient's health care. Numerous factors play a role in same-day cancellations, ranging from medical causes, patient factors, or administrative and scheduling conflicts.
Methods:
A retrospective review of the medical records database at our large tertiary academic referral center from 2007 to 2017 was performed to identify patients scheduled for vascular surgical procedures who experienced same-day cancellation.
Results:
Of the 17,887 scheduled vascular surgical procedures during the study period, 361 (2%) patients experienced same-day cancellations. Seventy-five percent of cancellations were determined to be nonforeseeable, 12.5% foreseeable, and 12.5% indeterminate. The most common reasons for cancellation were medical (55%), patient-initiated cancellation (12%), procedure no longer required (10%), and administrative or scheduling conflicts (10%). Twenty-six (7.3%) patients died within 30 days after their cancelled vascular operation. Most patients (69%) eventually received the planned operation, with a mean interval of 45.5 ± 135.8 days between cancellation and performance of the aforementioned procedure.
Conclusions:
At our institution, same-day cancellations of vascular surgical procedures were infrequent (2%). Most cancellations were due to medical reasons. Although most cancellations were determined to be nonforeseeable, emphasizing foreseeable cancellations may provide opportunities to improve patient care, enhance satisfaction, and reduce future cancellations.
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