Patient experiences with interventions to reduce surgery cancellations: a qualitative study
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
BMC Surgery 2013, 13:30 doi:10.1186/1471-2482-13-30Published: 8 August 2013
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.
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.
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.
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.