Reducing Surgical Cancellations in the Department of Orthopedic Surgery

The Department of Orthopedic Surgery (DOS) at Montefiore Medical Center provides comprehensive care for all orthopedic and musculoskeletal conditions. The DOS consists of ten subspecialties and five surgical facilities, treating more than 130,000 patients across the New York City Metropolitan area in 2014. The DOS engaged a Capstone team to assess causes of surgical cancellations—a critical impediment to their care delivery model—and quantify the financial and resource implications of these cancellations, with the goal of developing a remediation plan. To achieve that objective, the team conducted stakeholder interviews, process walkthroughs, and a thorough analysis of financial and cancellation data. Based on the team’s findings and industry best practices identified in a literature review, the team outlined a series of process enhancements and a pilot intervention to target and mitigate preventable cancellations.