Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement

Am J Surg. 2009 Nov;198(5):600-6. doi: 10.1016/j.amjsurg.2009.07.005.


Background: This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system.

Methods: CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities.

Results: Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive.

Conclusions: Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Data Collection
  • Efficiency, Organizational
  • Elective Surgical Procedures / economics
  • Elective Surgical Procedures / statistics & numerical data*
  • Hospitals, Veterans / organization & administration
  • Humans
  • Operating Rooms / organization & administration
  • United States
  • United States Department of Veterans Affairs / economics
  • United States Department of Veterans Affairs / organization & administration
  • United States Department of Veterans Affairs / statistics & numerical data*