Background: Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management,\nwhich can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH),\nwe identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention.\nMethod: We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014.\nCC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to\nidentify the effect of factors.\nResults: CC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment\nissues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%),\npatient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently\nperformed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of\nfemales (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly\nhigher than the other four weekdays.\nConclusions: Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs\namong doctors, and tendency of cancellation on Monday are the major identified factors, which account for a\nsignificant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce\nCR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed\npreoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex,\npaying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top\neight doctors, and improving surgery scheduling on Monday.
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