Elective orthopaedic surgery cancellations: insights into avoidable and unavoidable causes, consequences, and...

Cancellation of surgical procedures has significant physical, psychological, and financial consequences for patients and wastes hospital time and resources. Our study aimed to identify reasons for cancelling elective orthopaedic surgery at a district general NHS hospital and suggest interventions to address avoidable reasons for cancellation.

We performed a retrospective study to examine all elective orthopaedic procedures cancelled within 7 days of the intended surgery date for a year. The reasons for cancellation were classified as patient, clinical, or hospital factors.

We identified 600 cancellations, of which 47% were attributed to clinical factors, 25% to patient factors, and 28% to hospital factors. 48% of cancellations were for avoidable reasons, and 52% were for unavoidable reasons. 132 (25%) of cancellations happened on the intended day of surgery. The most significant avoidable reasons for cancellation were the patient unable to attend (13%), surgeon unavailability (8%), and lack of theatre time (6%). Administrative factors relating to staff availability, equipment, and pre-operative assessment accounted for 13% of cancellations.

Avoidable reasons were responsible for many cancellations and may be prevented through improved communication with patients and between staff. Unavoidable reasons may have root causes which can be tackled.