Article

Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement

Center for Surgical, Medical Acute Care Research and Transitions, Birmingham Veterans Administration Medical Center, Birmingham, AL, USA.
American journal of surgery (Impact Factor: 2.41). 11/2009; 198(5):600-6. DOI: 10.1016/j.amjsurg.2009.07.005
Source: PubMed

ABSTRACT This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system.
CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities.
Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive.
Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

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    • "This clinical dilemma often leads to same day surgical case cancellations resulting in delay and/or denial of the surgical care needed for these veterans. Same day case cancellation also results in wasting of the operating room (OR) resources and of valuable health care dollars [20]. Currently, there are no published guidelines to support the clinical decision making regarding perioperative management of patients with history of cocaine abuse [21]. Clinical practices vary widely based on individual anecdotes and personal experience. "
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