In 2024, the Pre-Operative and Post-Anesthesia Care Unit (PACU) team at Kaiser Permanente Sacramento Medical Center saw a chance to improve patient surgical readiness and efficiency to ensure timely access to surgical care. A data review showed 106 preventable same-day surgical cancellations, resulting in 18,209 minutes of lost operating room time and a significant financial impact. These cancellations also limited patient access to timely surgical care.

Led by Assistant Nurse Manager Basilio Dela Pena, MSN, RN, the team launched the Same-Day Cancellation Prevention Project in early 2025. The goal was to reduce preventable same-day cancellations by 30% (from 27 to 19 cases) by June 13, 2025. This would recover about 3,186 minutes of OR time and reduce financial losses.

A root cause analysis found key contributors to cancellations: patient confusion about preoperative instructions, lack of transportation, incomplete surgical preparation such as bowel prep, and late notification of surgery withdrawals. The team responded with targeted strategies for each issue:

• 72-hour pre-surgery outreach via email or phone to review fasting, medication management, and cancellation procedures.
• Simplified 24-hour reminders emphasizing only critical information.
• Encouragement of early cancellations to allow for surgical backfilling.
• Enhanced communication between pre-op nurses and OR schedulers to ensure timely updates.

During the 13-week pilot, results were impressive. Preventable same-day cancellations dropped from 27 to 13 cases, a 52% reduction that exceeded the goal.

“Explaining the why behind this initiative helped us gain staff buy-in,” said Dela Pena. “It’s about preparing our patients and protecting surgical care access.”