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Open Access Research article

Patient experiences with interventions to reduce surgery cancellations: a qualitative study

Einar Hovlid12*, Christian von Plessen34, Kjell Haug2, Aslak Bjarne Aslaksen56 and Oddbjørn Bukve1

Author Affiliations

1 Institute of Social Science, Sogn og Fjordane University College, Postbox 1336851 Sogndal, Norway

2 Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

3 Department of Thoracic Medicine & Infectious Disease, Hillerød Hospital, Hillerød, Denmark

4 Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway

5 Department of Radiology, Haukeland University Hospital, Bergen, Norway

6 Institute of Surgical Sciences, University of Bergen, Bergen, Norway

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BMC Surgery 2013, 13:30  doi:10.1186/1471-2482-13-30

Published: 8 August 2013

Abstract

Background

The cancellation of planned surgery harms patients, increases waiting times and wastes scarce health resources. Previous studies have evaluated interventions to reduce cancellations from medical and management perspectives; these have focused on cost, length of stay, improved efficiency, and reduced post-operative complications. In our case a hospital had experienced high cancellation rates and therefore redesigned their pathway for elective surgery to reduce cancelations. We studied how patients experienced interventions to reduce cancellations.

Methods

We conducted a comparative, qualitative case study by interviewing 8 patients who had experienced the redesigned pathway, and 8 patients who had experienced the original pathway. We performed a content analysis of the interviews using a theory-based coding scheme. Through a process of coding and condensing, we identified themes of patient experience.

Results

We identified three common themes summarizing patients’ positive experiences with the effects of the interventions: the importance of being involved in scheduling time for surgery, individualized preparation before the hospital admission, and relationships with few clinicians during their hospital stay.

Conclusions

Patients appreciated the effects of interventions to reduce cancellations, because they increased their autonomy. Unanticipated consequences were that the telephone reminder created a personalized dialogue and centralization of surgical preparation and discharge processes improved continuity of care. Thus apart from improving surgical logistics, the pathway became more patient-centered.

Keywords:
Quality improvement; Surgery; Cancellations; Patient centered; Qualitative