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.