1.1 INTRODUCTION
Cancellations of scheduled surgeries are a major cause of inefficiency amongst healthcare organisations worldwide. This is an ineffective use of theatre time and poses an additional cost to already limited surgical budgets. Cancellations are a setback for patients and their families, carrying psychological, social, and financial implications.1 In those suffering from life-threatening cardiac conditions, cancellations may have serious consequences.2 They pose an additional emotional burden, with reports of anxiety and fear of worsening cardiovascular health.3
The NHS reported an average cancellation rate of 7.5% (range 2.6 - 18.2%) for same day elective and urgent cardiothoracic surgeries with no differentiation between cardiac and thoracic cancellations.2 Previous international studies reported cardiothoracic cancellation rates of 1.96% - 24%.4, 5, 6, 7 The most common reasons for cancellations were reported to be patient-related factors, lack of available hospital beds, inadequate work-up, administrative shortfalls, and surgeon-related issues.6, 7, 8, 9, 10 A significant proportion of same-day cancellations were considered avoidable.7, 8
The primary aims of this study were to establish the frequency of same-day elective and urgent cardiac surgical cancellations at our Centre, to determine the reasons for these cancellations and the outcomes of patients whose operations were cancelled. Patient-reported outcomes and satisfaction are of growing importance in the patient-centred approach to healthcare. Thus, the secondary aims were to evaluate the impact of cancellations on patients using a patient satisfaction questionnaire and to identify measures to decrease cancellation rates, if found to be higher than national averages.