Title : Improving efficiency in elective hand surgery: A check and consent clinic model to reduce day-of-surgery cancellations
Abstract:
Elective hand surgery lists are often disrupted by last?minute cancellations or delays, usually due to unresolved medical issues, symptom changes, or incomplete consent particularly when there is a long gap between listing and surgery. To address this, we introduced a consultant?led “Check and Consent Clinic” to review patients shortly before their procedure.
We retrospectively reviewed all patients attending the clinic between April 2022 and January 2024. Day?case hand surgery patients were included, and clinic letters and operation notes were reviewed for demographics, management changes, and reasons for alteration.
67 patients were seen. 31 (46%) had a change in management:
•10 were converted to non?operative care (splints or injection)
•11 required no further treatment due to symptom resolution or comorbidities
•10 underwent a modified procedure (e.g., unilateral instead of bilateral, or change in approach)
•The clinic prevented 21 same?day cancellations, saving nearly four full?day operating lists. Based on NHS national tariffs, clinic costs were £11,323, while avoided procedures saved £23,940, giving a net saving of £12,617.
A pre?operative “Check and Consent Clinic” significantly reduced day?of?surgery cancellations and improved theatre efficiency. This model could be adapted to other elective orthopaedic pathways.
