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Surgical Innovation
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Causes of Cancellations on the Day of Surgery at Two Major University Hospitals

Andreas R. Seim, MS

Department of Computer and Information Science, Norwegian University of Science and Technology, Trondheim, Norway, andreas.seim{at}sintef.no

Tom Fagerhaug, MS, PhD

Department of Production and Quality Engineering, Norwegian University of Science and Technology, Trondheim, Norway

Sveinung M. Ryen, MS

Department of Production and Quality Engineering, Norwegian University of Science and Technology, Trondheim, Norway

Paige Curran, MA

Department of Psychology, Suffolk University, Boston, Massachusetts

Ola D. Sæther, MD, PhD

Department of Surgery, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

Hans O. Myhre, MD, PhD

Department of Surgery, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway, Department of Circulation and Medical Imaging Norwegian University of Science and Technology, Trondheim, Norway

Warren S. Sandberg, MD, PhD

Department of Anesthesia, Harvard Medical School, Department of Anesthesia and Critical Care, Massachusetts General Hospital Boston, Massachusetts

Cancellations of elective cases on the day of surgery waste valuable operating-room time. The authors studied cancellations at an American hospital and a Norwegian university hospital to test (a) whether the quality of hospital administrative data on cancellations is sufficient for meaningful comparative analysis and (b) whether causes of cancellations at these 2 major academic hospitals are comparable. Large retrospective cause-of-cancellation data sets were obtained from each hospital. The authors then prospectively established root causes of cancellations by on-site investigation and interviews of the hospital personnel involved. The surgical department at the Norwegian hospital cancelled 14.58% of cases in 2003 and 16.07% in 2004. The American hospital cancelled 16.52% of all cases between May 1, 2003, and April 30, 2004. Administrative data may give a rough picture of causes of cancellations. However, most findings at either of the hospitals do not translate easily to the other.

Key Words: cancellations • operating room management • preoperative care/management/optimization • economics • quality • cancellations on day of surgery • hospital capacity • causes of cancellations

This version was published on June 1, 2009

Surgical Innovation, Vol. 16, No. 2, 173-180 (2009)
DOI: 10.1177/1553350609335035


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