Exploring factors leading to same-day cancellations of elective surgical procedures

Background/Aims Last-minute cancellations of elective surgeries lead to inefficient use of operating theatre time and resources. There are many potential reasons for cancellations. This study aimed to identify and explore factors leading to same-day cancellations of elective surgeries in India. Methods A prospective cross-sectional study was conducted at a large private hospital in Bangalore, India. Data were collected from the hospital records on all elective surgeries scheduled during a 3-month period, including the number of same-day cancellations and the reasons for these cancellations. Cancellations were categorised according to whether they were caused by hospital-related or patient-related factors, and whether they were considered avoidable. Pareto analysis was conducted to identify the major contributing factors for avoidable same-day cancellations. Results Of the 3998 elective surgeries scheduled during the study period, there were 534 (13.4%) cancellations, of which 365 (68.4%) were potentially avoidable. The majority of the potentially avoidable factors were hospital related (n=222, 60.8%). Pareto analysis found that 80% of potentially avoidable cancellations could be explained by five factors: dummy bookings, lack of affordability, delays in insurance approvals, the patient rescheduling for personal reasons and the patient being unwilling to undergo surgery. Conclusions A large proportion of same-day cancellations of elective procedures could be prevented by addressing avoidable patient- and hospital-related contributing factors. Targeting these issues collaboratively is crucial to improving the efficiency of elective hospital care and preventing waste in operating theatres. Implications for practice Hospitals should conduct regular internal audits to identify the reasons for same-day cancellations of elective surgeries and target the potentially avoidable factors. Multidisciplinary and inter-departmental collaboration is important to effectively tackle same-day cancellations.