Respectful approach to day-of-surgery cancellations developed to reduce patient emotional harm

Day-of-surgery cancellations impose documented emotional and time-related burdens on patients, and a new study reports the systematic development of a complex intervention designed to manage unavoidable cancellations in a way that reduces that emotional harm. The research, published in BMC Health Services Research, describes the creation of an intervention called Respectful Day-of-Surgery Cancellation. Importantly, the study reports the development of the intervention rather than its tested effectiveness, and the authors state that further feasibility testing and evaluation are warranted.

The development work was guided by the Medical Research Council framework and Hawkins et al.’s co-production model, and proceeded in three phases: an evidence review combined with primary data collection, co-production, and prototyping. The data sources included qualitative interviews with healthcare professionals, four co-production workshops, and patient interviews used during prototyping. All data were analysed using inductive content analysis. To ensure transparent reporting, the researchers used the GUIDED checklist, and the intervention components were described according to the TIDieR guidance.

The development process ran between May 2022 and December 2024 and produced a multicomponent intervention operating at two organisational levels. Its components comprise timely cancellation decision-making, communication skills training for nurses, and multiple components addressing patients’ informational needs throughout the cancellation trajectory. These components were integrated into a guide for respectful and supportive management of day-of-surgery cancellations.

The intervention was designed with intended outcomes of reduced waiting time, uncertainty, and emotional distress while upholding patients’ trust in the healthcare system. The authors note that while interventions exist to prevent cancellations, no interventions were identified that specifically addressed the management of unavoidable cancellations and their emotional impact, which is the gap this development work set out to address. Respect serves as the guiding principle of the approach, which is intended to support dignified and compassionate cancellation management.

Because the published results describe the development of a theory- and evidence-informed intervention rather than an evaluation of its effects, the reported reductions in waiting time, uncertainty and emotional distress are intended outcomes, not demonstrated results. The study provides a foundation for the feasibility testing and evaluation that the authors say are needed before any conclusions about real-world impact can be drawn.

Subject of Research: Development of a complex intervention for respectful management of unavoidable day-of-surgery cancellations

Article Title: Reduction of emotional harm by a respectful approach for managing day-of-surgery cancellation: systematic development of a complex intervention

Article References: Viftrup, A., Holm, A., Kristensen, P. K., Laustsen, S., & Dreyer, P. (2026). Reduction of emotional harm by a respectful approach for managing day-of-surgery cancellation: systematic development of a complex intervention. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15883-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15883-3

Keywords: day-of-surgery cancellation, patient emotional distress, complex intervention, MRC framework, co-production, communication skills training, health services research, patient information needs, nurses, feasibility testing, Reduction, emotional