A cross-sectional study investigating the rate and determinants of elective case cancellations at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Background: Cancellations of planned surgical procedures are a major and long-standing problem for healthcare organizations around the world. This study aimed to determine the rate and determinants of elective case cancellation at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia.

Methods: A cross-sectional study was conducted from 1 March 2018 through 28 February 2019 to determine rate of case cancellation and determinants of cancellation. Data were collected using a structured form and entered into SPSS software for descriptive analysis.

Results: The overall cancellation rate during the study period was 8.9%. The highest cancellation rates were for gynaecologic procedures (18.3%). Among the cancelled patients, 65.9% were younger than 45 years, 88% had haematocrit values >30%, 89.4% had no associated comorbidities, and 89.8% were classified as American Society of Anesthestiologists class I or II. Administration-related factors, which accounted for 73.1% of cancellations, were the most frequently cited reasons for cancelling elective procedures; specifically, problems associated with the Central Sterilization and Supply Department were the leading causes for case cancellations.

Conclusions: Most of the cancelled patients were young and fit for both surgery and anaesthesia. Avoidable administrative factors were the most common reasons for cancellation. The hospital should consider these factors to strategize interventions as well as devise policies and quality improvement projects.