Elective surgical case cancellations at siriraj hospital, a Thai University Hospital: Identification and evaluation of the reasons

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Objective: To determine the incidence of elective surgical case cancellations and the reasons for the cancellations at Siriraj Hospital, Thailand, during a one-year period. Materials and Methods: A retrospective cross-sectional analytic study was conducted from May 2016 to April 2017. All data on case cancellations of elective surgical procedures were retrieved. The reasons for the cancellations were extracted from the hospital’s medical records, analyzed separately for outpatient and inpatient settings, and classified into one of 6 categories: patient issue, hospital-facility issue, surgeon issue, anesthesiologist issue, medical condition, and miscellaneous. Results: Of48,784 scheduled elective procedures, 2,760 cases were cancelled, representing an incidence of 5.7% (95% CI 5.5 to 5.9). The highest number of case cancellations occurred in the Gastrointestinal Endoscopy Unit (37.4%). The most common category for cancellations in the outpatient department [OPD] setting was patient issue (54.1%), with the most common reason being patient no-show (41.5%). However, in the inpatient department [IPD] setting, hospital-facility issue was the most common category, with an improperly estimated case-time being the most common reason (20.8%). Conclusion: Cancellations occurred for 5.7% of elective surgical cases, and they were due primarily to the patient and hospital-facility factors of patient no-show and improperly estimated case-time, respectively. Strategies to improve hospital management and the information sharing between medical units are needed to reduce the overall level of elective surgical case cancellations caused by patient and hospital-facility issues.