The impact of surgical cancellations on children, families, and the health system in an Australian paediatric tertiary referral hospital
Study Type: Prospective audit over 6 months to identify the frequency, cause & impact of surgical cancellations in a tertiary paediatric hospital.
Methods: Telephone survey of 750 parents of children that had their planned surgery cancelled.
Findings: Relatively high cancellation rate (14%) that was predominantly hospital initiated. The later the cancellation, the more financially and emotionally detrimental it was.
It is clear that surgical cancellations are detrimental to both families and the health sector due to lost productivity. The biggest factor for cancellation was the patient being acutely unwell or failing to attend the hospital for their procedure. These reasons were closely followed by the need for an emergency procedure which took priority on the day of intended surgery. I suspect that this is going to be similar across the board. Understanding this, the authors have increased nurse-led pre-admission style calls to confirm planned attendance, screen for coryzal symptoms and clarify fasting instructions. Hopefully this can reduce day of surgery (DOS) cancellations and create a platform that other centres may be able to utilise. Of note, greater negative emotional reactions to DOS cancellations were observed in patients who were fasted. Unfortunately, 61% of these children fasted from clear fluids for > 3 hours. Given the now very widespread acceptance and preference for clear fluid intake until 1 hour prior to surgery, this is a valuable reminder for us to develop a system that promotes such consumption.
Reviewed by Dr Nathan Hewitt