Fishbone — Day-of-Surgery Cancellations
Ishikawa analysis of elective operations cancelled on the day at a district general hospital, split across patient, bed, staffing, list planning, equipment and preoperative assessment causes.
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title "Why are elective operations cancelled on the day?"
problem "Day-of-surgery cancellations"
category "Patient"
cause "Unfit on arrival, new chest infection"
cause "Did not fast as instructed"
cause "Did not attend"
category "Beds"
cause "No critical care bed for a planned admission"
cause "Ward bed taken by an emergency overnight"
category "Staffing"
cause "Anaesthetist redeployed to obstetrics"
cause "Scrub practitioner vacancy on the list"
category "List planning"
cause "List overbooked against realistic times"
cause "Case order not agreed until the morning"
category "Equipment"
cause "Loan set not delivered or unsterile"
cause "Imaging stack faulty in theatre 4"
category "Preoperative assessment"
cause "Anticoagulant not stopped in time"
cause "Missing echocardiogram result"