Telfer School of Management, University of Ottawa , Ottawa, ON, Canada.
Department of General Surgery, University of Ottawa Faculty of Medicine , Ottawa, ON, Canada.
Int J Circumpolar Health. 2020 Dec;79(1):1816678. doi: 10.1080/22423982.2020.1816678.
Colonoscopy is a critical diagnostic and therapeutic procedure that is challenging to access in northern Canada. In part, this is due to frequent cancellations. We sought to understand the trends and reasons for colonoscopy cancellations in the Northwest Territories (NWT). A retrospective review of colonoscopy cancellations January, 2018 to May, 2019 was conducted at Stanton Territorial Hospital, NWT. Cancellation details and rationale were captured from the endoscopy cancellation logs. Thematic analysis was used to group cancellation reasons. Descriptive statistics were generated, and trends were analysed using run chart. Of the scheduled colonoscopies, 368(28%) were cancelled during the 16 month period, and cancellations occurred, on average, 27 days after booking. Cancellation reasons were grouped into 15 themes, encompassing personal, social, geographic and health system factors. The most frequently cited theme was work/other commitments (69 respondents; 24%). Cancellations due to travel and accommodation issues occurred more frequently in the winter. Over one in four booked colonoscopies were cancelled and the reasons for cancellations were complex. Initiatives focusing on communication and support for patients with personal or occupational obligations could dramatically reduce cancellations. Ongoing collaborative efforts are needed to inform and optimise access to colonoscopy in this region.
结肠镜检查是一项关键的诊断和治疗程序，但在加拿大北部难以进行。部分原因是经常取消。我们旨在了解西北地区（NWT）结肠镜检查取消的趋势和原因。 在 NWT 的斯坦顿地区医院，对 2018 年 1 月至 2019 年 5 月期间的结肠镜检查取消情况进行了回顾性研究。从内窥镜取消记录中获取了取消详细信息和理由。使用主题分析将取消原因进行分组。生成描述性统计信息，并使用运行图分析趋势。 在预定的结肠镜检查中，16 个月期间有 368 次（28%）被取消，取消平均在预约后 27 天发生。取消原因分为 15 个主题，包括个人、社会、地理和卫生系统因素。最常提到的主题是工作/其他承诺（69 名受访者；24%）。由于旅行和住宿问题导致的取消在冬季更为频繁。 预约的结肠镜检查中有四分之一以上被取消，取消的原因很复杂。针对有个人或职业义务的患者的沟通和支持计划可能会大大减少取消。需要持续合作，为该地区提供信息并优化结肠镜检查的机会。
