Effectiveness of a preoperative checklist in reducing surgery cancellations in a tertiary hospital in a low-income country

Abstract

Background: A high surgery cancellation rate has been a problem at Muhimbili National Hospital for a decade, ranging from 16% to 29%, with patient factors accounting for up to 40% of cancelled surgeries. One critical aspect of addressing the problem was the implementation of a preoperative checklist to double-check the preoperative workup and reduce cancellations due to patient factors. This paper aimed to determine the effectiveness of a preoperative checklist in reducing the cancellation rate of planned surgeries.

Methods: A 6-month quasi-experimental study was conducted at Muhimbili National Hospital. We enrolled 298 and 300 patients in the control and interventional phases, respectively. The data was gathered using a pre-tested checklist, coded, entered, and analysed using SPSS version 22.0.

Results: The checklist implementation reduced the cancellation rate from 19.1% to 16.3%, with patients' factors significantly decreasing from 46 (15.4%) in the control group to 14 (4.7%). p=0.000.

Conclusions: A preoperative checklist reduces cancellations due to patient factors and is a promising tool for reducing surgery cancellations. It is recommended that the preoperative checklist be used regularly at MNH to reduce surgical cancellations.