Sustainability: orthopaedic surgery wait time management strategies

Area of Science:

• Health Services Research
• Healthcare Management
• Surgical Outcomes

Background:

• Federally established wait time limits are a key performance indicator in Canadian healthcare.
• Maintaining surgical wait times within these limits presents significant organizational and systemic challenges.

Purpose of the Study:

• To investigate Canadian organizational and systemic factors enabling sustained compliance with federal wait time limits for at least 18 months.
• To identify characteristics differentiating successful and unsuccessful wait time management in surgical settings.

Main Methods:

• A multiple case study design was employed, analyzing three distinct cases of surgical wait time management.
• Data collection involved interviews with key personnel and document analysis, focusing on systemic and organizational factors.
• Factors examined included governance, leadership, culture, resources, methods, and tools.

Main Results:

• The hospital maintaining compliance had an exclusive focus on hip and knee replacements, highly motivated staff, and a strong team spirit.
• Case 2 partially met requirements but could not sustain them, while Case 3 never met the targets.
• Success was linked to a specialized operational model, akin to a 'hospital factory'.

Conclusions:

• A gradient exists in factors influencing wait time sustainability across different healthcare settings.
• The specialized 'hospital factory' model shows promise for super-specialized surgery but requires careful patient selection.
• Findings highlight the importance of organizational structure, staff engagement, and operational focus in managing surgical wait times.