Same-day surgical cancellations in pediatric urology: identifying trends for quality improvement

Day of surgery cancellations present several workflow challenges that result in delay of care for patients and revenue loss for physicians. This study aimed to further understand same-day pediatric urology surgical cancellations, and the authors assessed identifiable trends for quality improvement over a one-year time period.

Same-day surgical cancellations were prospectively identified at a single tertiary care center, Atrium Health Wake Forest Baptist, from 01 October 2022 to 30 September 2023. Reasons for cancellation were recorded per the parent/legal guardian and categorized as an avoidable or unavoidable cause. Demographic data, surgical rescheduling, and lost operating room time were also recorded. Descriptive and bivariate analyses were performed as indicated.

Of 2351 scheduled cases, 51 (2.2%) were cancelled the day of surgery. The most common cancellation type was a complete no-show with no reason provided from the family (39.2%). Of those with reported reasons, 54.8% were cancelled for avoidable causes. Of those cancelled, 66.7% were for patients of a minority race, with 11.8% of families indicating a need for translation services during visits. There was no difference in terms of race/ethnicity, distance lived from the hospital, or surgical type when comparing cancellation reason (p > 0.05). Only 51.0% of cases were rescheduled with a median delay of 38 days. A total of 59.3 h of operating room time was lost due to these cancellations.

Same-day cancellations were identified in 2.2% of planned pediatric urology cases over a one-year period, with the majority of patients cancelled for avoidable reasons. Of cancelled cases, only 51.0% were rescheduled by the family, with a median delay of over one month. Additionally, 2/3rd of patients identified as a minority race, with 11.8% requiring translation services. This represents a vulnerable population who may require additional counseling for optimal patient and provider outcomes.