Risk Factors and Reasons for Cancellation Within 24 Hours of Scheduled Elective Surgery in an Academic Medical Centre

The Operating Theatre (OT) is the largest cost centre as well as the main revenue generator in most hospitals. One of the common problems affecting optimal OT utilization is the cancellation of scheduled surgeries. The goal of this study was to identify factors associated with cancellation within 24 hours of scheduled surgeries in a tertiary hospital

Study Overview

• Status: Completed
• Conditions: Operating Theatre Cancellations

Detailed Description

The Operating Theatre (OT) is the largest cost centre as well as the main revenue generator in most hospitals. The operating theatre involves significant resources - materials, medications and manpower. One of the common problems affecting optimal OT utilization is the cancellation of scheduled surgeries. This results in a significant waste of resources, especially when cancellation occurs within 24 hours of the scheduled surgery, when it is too late to arrange replacement surgery. Cancellation also impacts the patient and their families.

Reported cancellation rates range between 5% to 40%. Reasons for cancellations vary, including patient factors, surgeon factors, and system issues relating to the preoperative anaesthesia assessment clinic attendance, the surgery itself, and the availability of post-surgical care facilities. Between 60% to 90% of cancellations have been reported to be potentially avoidable.

The goal of this study was to identify factors associated with cancellation within 24 hours of scheduled surgery in a tertiary academic hospital, and the reasons for cancellation, with the goal of identifying areas for intervention to reduce avoidable surgery cancellations and reduce unnecessary waste.

• Study Type: Observational
• Enrollment (Actual): 4060

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The median patient age was 68 years (IQR 63 - 75 years), with 44% being male patients and 80% Chinese. Majority were Singapore citizens or permanent residents (98%). Two-thirds of the surgical patients were in a subsidized ward class (2665, 66%). Only 2% required Medifund assistance.

Description

Adult patients (age 18 years and older) who were scheduled for elective surgery at the Singapore General Hospital main operating theatre or ambulatory surgical centre, regardless of surgical discipline, or residency, were included in the study. Only the first surgery in the study period was included if a patient had multiple surgeries over this period. Minor surgeries under local anaesthesia were also excluded. We excluded those without previous admissions in the past 3 years prior to the surgery, as data for chronic disease history and healthcare utilization patterns were not available for these patients

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Surgical patients; Patients who were electively scheduled for surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cancellation	Cancellation of surgery within 24 hours of procedure	24 hours of surgery

Collaborators and Investigators

• Sponsor: Singapore General Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 1, 2015
• Primary Completion (ACTUAL): December 31, 2016
• Study Completion (ACTUAL): December 31, 2016

Study Registration Dates

• First Submitted: January 18, 2019
• First Submitted That Met QC Criteria: January 18, 2019
• First Posted (ACTUAL): January 22, 2019

Study Record Updates

• Last Update Posted (ACTUAL): January 22, 2019
• Last Update Submitted That Met QC Criteria: January 18, 2019
• Last Verified: January 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: 2018-2286

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No