Elective orthopaedic procedure cancellations within 24 hours: Are they a problem?

Introduction: Surgical cancellations have been a long-standing issue in the United States health care system, with orthopaedic surgery having some of the highest cancellation rates among all specialties. Purpose: This study aims to assess the reasons for surgical cancellations by exploring patient, surgeon, and institutional factors. Methods: A retrospective chart review of elective orthopaedic surgery procedures performed at an academic outpatient hospital between January 2019 and August 2024 was conducted. Results: Total joint and hand procedures had the highest relative cancellation rates. Among the subspecialties, trauma and joints were the most common. The predominant reasons for cancellation were patient-related, surgeon-related, clerical issues, medical/anaesthesia-related matters, and COVID-19, respectively. The most common patient-related factors included clearance, lack of transportation, and patient noncompliance with day of surgery instructions (eating, drinking, and medications). Conclusion: This study highlights opportunities for interventions to reduce same-day cancellations through patient engagement, preoperative planning, resource coordination, and administrative efficiency.