Reduction of last-minute cancellations in elective urology surgery: A quality improvement study

Abstract

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.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.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.Cancelled operations represent poor use of resource. The bulk of common cancellation reasons can be addressed with a reminder telephone call covering admission instructions.