Cancellation in CMA: incidence and causes

IntroductionMajor Ambulatory Surgery (MAS) units are becoming increasingly important and require correct management. One of the principal improvement parameters in hospital management policy is the rate of cancellations of elective surgery.Material and methodWe designed a retrospective, observational study by selecting all the patients operated on in our MAS unit from 1995 to 2009: 16.934 patients. We analysed the surgical procedures cancelled the day before the operation.ResultsA total of 701 patients (4.1%) had a scheduled surgical intervention cancelled. This cancellation occurred the day before the operation in 343 patients (2%) and on the same day of the operation in 358 patients (2.1%). Reasons for the cancellation: acute intercurrent disease in 180 patients (25.7%), personal decision of the patient in 126 (18%), non-appearance of the patient in 28 (4%), incorrect preparation of the patient in 190 (27.1%), lack of resources in 177 (25.2%). Distributing the reasons for cancellation according to the possibility of preventing them; 369 cancellations (52.6%) could be avoidable, 43 (6.2%) potentially avoidable, 177 (25.2%) difficult to avoid, and 112 (16%) unavoidable.ConclusionsMore than half of the cancellations could have been avoided. We recommend improvements in the replacement of already scheduled patients. Information campaigns would be needed to increase the awareness of the population on the real cost of health services. Improvement measures would also be needed to improve the selection-evaluation of patients with pre-operative protocols/assessment units.