|
11. Cancellation/Postponement of Surgery
- It is deeply distressing to a patient to have an operation postponed on the day
of surgery and economically wasteful both for the patient and the NHS.
- Many cancellations could be avoided with good pre-operative assessment,
effective bed management and better communication between patient and
hospital, and between staff groups within the hospital.
- Data from the nine pilot sites of the NHS Theatre Project show a variety of
reasons for cancellation of surgery at short notice.
- The management team should undertake a regular review of all cancellations.
11.1 Dealing with the patient whose operation has to be postponed for
non-clinical reasons:
- Local procedures should be developed for dealing with cancellation of surgery
at short notice. A senior member of the team should visit the patient as soon as
possible after the decision is made and offer an appropriate apology and an
explanation. 'The patient must be offered another binding date within a
maximum of the next 28 days or funding provided for treatment at the time and
hospital of the patient’s choice' .
- The patient should be provided with something to eat and drink as soon as
possible, access to a telephone and offered help with arrangements for transport
home if appropriate.
- There should be full documentation of the reasons for cancellation, the
explanation given and any action taken in the patient’s record.
11.2 Dealing with the patient whose operation is cancelled for
clinical reasons:
- It may be necessary to cancel an operation because of a new or inadequatelytreated
medical condition, or exacerbation of chronic illness.
- Most pre-existing medical conditions should be detected and treated following
screening and/or in the pre-operative assessment visit, providing pre-assessment
is carried out within two weeks of admission.
- In the event of the system failing, the patient deserves an appropriate apology
and an explanation.
- It is unacceptable to cancel surgery without arranging suitable referral or
treatment. It is the responsibility of the clinician to document exactly what
investigations and/or treatment are required and the responsibility of the preoperative
assessment team to ensure that this is carried out.
- A review of the reason for failure of the system should be carried out.
|