ROOT CAUSE ANALYSIS OF THEATRE CANCELLATION IN BASSETLAW HOSPITAL – ARE WE MISSING THE TARGET?

Introduction

Theatre cancellation is unpleasant experience to patient and it is expensive to service provider. There are various causes for cancellation which are avoidable and unavoidable as well. Nationwide, there has been several measures put in place to reduce avoidable theatre cancellations.

We describe retrospective review of 158 cancellations and root cause analysis & solutions in relation to the National standard.

Material & Method

Retrospective review of all orthopaedic theatre cancellations, both elective and trauma cases, case notes & registry review as made for the period of 1st of August 2007 to 2005 to 31^st of March 2009 in Bassetlaw Hospital. Data was collected and analysed.

Results

• Total Number of Operation -3315

• Time of cancellation –

• Same Day of Operation 157

• Day before operation 1

• Total Number of cancellation – 158

• Total Number of IP – 66

• Total Number of Day cases – 92

Almost all cancellations were on same day. All cancellations are in Theatre. Majority are cancellation by the anesthetist in charge.

Conclusion

Theatre cancellation is expensive and unpleasant experience both to the patient and the surgeon. From root cause analysis we found avoidable proportion of - 76.6%. No link was found on pre-assessment clinic to avert the cancellations.

We recommend Managerial improvement in theatre especially in the following highlight points.

1. Instrument handling and packaging

2. Early communication of anaesthetist and surgeon involved

3. Early admission time for surgery

4. Increase awareness to theatre manager and to follow the performance indices