Incidence and causes of ocular surgery cancellations in an ambulatory surgical center

Purpose

To report the incidence and analyze potentially preventable causes of ocular surgery cancellations.

Setting

Ambulatory Care Surgical Center of the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.

Methods

A retrospective review of the ambulatory surgical center cancellation records and patient medical records from December 2001 to December 2003 was conducted. The primary statistical analysis was conditional logistic regression.

Results

Three hundred seventy-nine of 7153 (5.3%) ambulatory ophthalmic surgeries were cancelled within 24 hours of the scheduled start time. Cancellation rates varied by patient age, with the rate among children being highest (8.7%) and that among older patients (age 60+) lowest (4.9%; P = .08). Surgeons who performed at least 4 surgeries per month on average had the lowest cancellation rate (P = .08). Cancellations occurred less frequently in warmer months (June, 3.3%; August, 4.2%) than during the rest of the seasons (P<.001). The highest incidence of cancellations occurred in February (7.8%) and the lowest in June (3.3%). Of the total causes, 41% were considered “preventable,” 45% “unpreventable,” and 14% “no reason given.” Cancellations deemed preventable were lower in general anesthesia cases (1.0%) than in local anesthesia cases (2.0%; P = .02). Preventable cancellation rates also varied by procedure and were statistically significant.

Conclusions

Among ambulatory ophthalmic surgeries, there was a higher incidence of late cancellations in pediatric cases. Late cancellation rates were highest in cases scheduled in the winter, especially in February. Of the reasons documented for cancellations, 41% were considered “preventable” with proper preoperative counseling and instructions. The costs of late cancellations to the particular institution are estimated to be at least $100 000 per year, or nearly 1 month of scheduled surgeries in a 2-year period.