INTRODUCTION Postponement of surgery at preoperative assessment in the days or weeks before the patient is admitted for surgery, as distinct from cancellation on the planned day of surgery, can be devastating for patients and an inefficient use of finite resources. However, postponements are often poorly recorded. The primary aim of this pilot study was to investigate elective surgical postponement rates during or after preoperative assessment across England, and the reasons for postponement for patients on an elective surgical pathway. METHODS A retrospective analysis of clinical audit data from 16 National Health Service (NHS) trusts in England was undertaken. Data were collected during a two-week period in March 2024 on all postponements within a service. The primary outcome of interest was the postponement rate. RESULTS Some 8000 case notes were reviewed. There were 583 (7.3%) postponements. Postponement rates across trusts varied from 31.9% to 1.0%. Significantly shorter time from referral to preoperative assessment was observed for day-case patients, urgent patients, patients without early screening and patients without a 'to come in' date in place. Of the 342 routine patients, 293 (85.7%) had postponements for medical rather than pathways or process reasons. Half of all routine patients waited over 94 days and a quarter of patients waited 198 days from being added to a patient tracking list to preoperative assessment. CONCLUSIONS Minimizing postponements and improving preoperative assessment efficiency should be part of wider initiatives to streamline perioperative pathways.

中文翻译：

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英格兰 NHS 手术延迟率的变化。


引言 在患者入院手术前几天或几周内进行术前评估时推迟手术，与在计划手术当天取消手术不同，对患者来说可能是毁灭性的，并且对有限资源的利用效率低下。然而，推迟的记录往往很糟糕。这项试点研究的主要目的是调查英格兰各地术前评估期间或之后的择期手术推迟率，以及择期手术途径患者推迟的原因。方法 对来自英格兰 16 个国家医疗服务 （NHS） 信托基金的临床审计数据进行了回顾性分析。数据是在 2024 年 3 月的两周内收集的，涉及服务内的所有延迟。感兴趣的主要结局是延迟率。结果 回顾了大约 8000 份病例记录。有 583 次 （7.3%） 推迟。信托的延期率从 31.9% 到 1.0% 不等。观察到日间病例患者、紧急患者、未进行早期筛查的患者和未确定“就诊”日期的患者从转诊到术前评估的时间显著缩短。在 342 名常规患者中，293 名 （85.7%） 因医疗原因而非途径或过程原因推迟。一半的常规患者等待了 94 天以上，四分之一的患者从被添加到患者跟踪名单到术前评估等待了 198 天。结论 尽量减少推迟和提高术前评估效率应该是简化围手术期路径的更广泛举措的一部分。