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Reduction of last-minute cancellations in elective urology surgery: A quality improvement study
S Sweetman1, A R Sharkey1, K Thomas2
1Proactive Care of Older People Undergoing Surgery Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Background:
Last minute cancellations of elective surgery negatively impact both patients and hospitals, leading to inefficient use of resources, reduced capacity and increased waiting lists. The aims of the study were: to determine the last-minute cancellation rates in a tertiary urology department, to analyse the reasons driving cancellations, and to implement targeted solutions.
Method:
Process mapping was used to analyse the patient journey, and a retrospective service evaluation of 6 months of urology operations was conducted. Interventions were designed based on addressing the most common cancellation reasons, and the audit cycle was completed with a further 6 months of post-intervention data collection.
Results:
In the first 6 month period we reviewed, there were 2773 scheduled operations, of which 334 resulted in a last minute cancellation (12% of scheduled operations). The top four cancellation reasons were: Targeted interventions, including a reminder telephone call, resulted in a modest reduction (0.2%) in the rate of last-minute cancellations in the following 6 months.
Conclusions:
Cancelled operations represent poor use of resource. The bulk of common cancellation reasons can be addressed with a reminder telephone call covering admission instructions.
