Prevalence, causes, and staff perception of same-day elective surgery cancellation at a university hospital: a mixed study.

Abstract

Background: Same-day elective surgery cancellations disrupt healthcare efficiency by wasting resources and increasing costs due to repeated preparations and extended hospital stays. Beyond the financial toll, delays in necessary procedures can worsen health conditions, heighten patient anxiety, and prolong recovery times. These cancellations also place emotional and logistical burdens on patients and families, further amplifying their impact. This study aimed to determine the prevalence of same-day elective surgery cancellations at the El-Demerdash University Hospital in Egypt, identify the underlying causes-including hospital-related, patient-related, and staff-related factors-and explore the perceptions of operating room (OR) staff regarding these causes.

Methods: A mixed-methods approach was used, combining quantitative and qualitative components. The quantitative component was a cross-sectional study including the prospective collection and analysis of 993 elective surgeries performed in 21 ORs at El-Demerdash University Hospital. The qualitative component involved 25 OR staff members and comprised two focus-group discussions with OR nurses, as well as 15 in-depth interviews with surgeons, anesthesiologists, and OR secretaries.

Results: The cancellation rate for same-day elective surgeries was 12.59%. Key reasons for cancellation included unavailable OR time (24.03%), lack of ICU beds (21.71%), changes in the patient's medical condition (14.73%), prolonged previous surgeries (10.85%), and equipment issues (7.75%). The qualitative analysis revealed that most OR staff expected a cancellation rate of 10-20%, identifying ICU bed unavailability and changes in patient condition as the primary contributing factors.

Conclusion: Same-day elective surgery cancellations at El-Demerdash University Hospital are lower than the rates reported in most developing countries but remain higher than the international efficiency benchmark. The leading causes are primarily avoidable and hospital related. To improve OR utilization, strategic management interventions targeting the key causes are recommended. These include optimizing the OR booking system, improving department communication, and ensuring proper preoperative patient preparation and education and better resource allocation.