What the research shows, and what it does not.
SynaptoFlow has not been studied. The sources below explain why preparation and clear records matter. None of them is evidence that this product works.
Sources, with their limits
1 Zafar A, Mufti TS, Griffin S, Ahmed S, Ansari JA. Cancelled elective general surgical operations in Ayub Teaching Hospital. J Ayub Med Coll Abbottabad. 2007;19(3):64-6.
What it showsOver one year, 936 of 3,756 scheduled elective general surgery cases (25%) were cancelled. Reasons: insufficient theatre time 338 (36%), medical factors 296 (31.6%), no bed 152 (16.2%), anaesthetist unavailable 55 (5.8%). The anaesthetist cancelled 43% of cases, the surgeon 39%, and 18% were organisational.
What it does not showIt does not measure patient preparation as a cause. Its authors concluded that most cancellations were due to reasons other than the patient’s medical condition. An earlier version of this website described the 43% figure as "patient preparation failures"; that was wrong, and it has been removed.
2 Schofield WN, Rubin GL, Piza M, Lai YY, Sindhusake D, Fearnside MR, Klineberg PL. Cancellation of operations on the day of intended surgery at a major Australian referral hospital. Med J Aust. 2005;182(12):612-5.
What it showsOf 7,913 theatre bookings scheduled by 133 surgeons, 941 (11.9%) were cancelled on the day. The authors estimated 60% of elective cancellations were potentially avoidable. Leading reasons included no theatre time (18.7%), no post-operative bed (18.1%), cancellation by the patient (17.5%) and a change in the patient’s clinical status (17.1%).
What it does not showIt is a single Australian hospital in 2005. It shows patient-side reasons are a large share of cancellations elsewhere too; it says nothing about any software.
3 Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-9.
doi:10.1056/NEJMsa0810119 · PMID 19144931
What it showsAcross eight hospitals in eight countries, introducing the WHO Surgical Safety Checklist was associated with a fall in major complications from 11.0% to 7.0% and in inpatient deaths from 1.5% to 0.8%.
What it does not showIt is a before-and-after study of the checklist done properly in theatre. It is not evidence that a digital version, or this one, has the same effect.
4 Ivers N, Jamtvedt G, Flottorp S, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;(6):CD000259.
doi:10.1002/14651858.CD000259.pub3 · PMID 22696318
What it showsThe review included 140 studies. In its main analysis (82 comparisons from 49 studies), audit and feedback produced a weighted median absolute improvement in compliance with desired practice of 4.3% (interquartile range 0.5% to 16%).
What it does not showThe effect is real but usually modest and varies widely. We cite it as the honest expectation for any tool that shows clinicians what has and has not been done.
5 Waller A, Forshaw K, Carey M, Robinson S, Kerridge R, Proietto A, Sanson-Fisher R. Optimizing patient preparation and surgical experience using eHealth technology. JMIR Med Inform. 2015;3(3):e29.
What it showsA discussion paper describing where electronic tools could support each stage of surgical care, including pre-operative preparation, discharge planning and follow-up.
What it does not showIt is not a trial or a systematic review, and it reports no effect size. Its authors call for rigorous intervention studies. So do we.
How we will measure it
Each design-partner unit records, for three months before and three months after starting: elective cases listed, cases cancelled on the day, and the reason for each cancellation using the same categories as reference 1.
SynaptoFlow records the reason when a case is postponed or cancelled, so the after period needs no separate log. The before period comes from the unit's own theatre register. We will publish the result whichever way it goes.