Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: Dec 9, 2021
Date Accepted: Feb 22, 2022
Date Submitted to PubMed: Dec 10, 2021
Implementation of a Canadian Weekend Elective Paediatric Surgery Program to Reduce COVID-19 Related Backlog: Operating Room Ramp-Up After COVID-19 Lockdown Ends – Extra Lists (ORRACLE-Xtra)
ABSTRACT
Background:
The COVID-19 pandemic caused by the SARS-COV-2 virus has resulted in unprecedented challenges for the healthcare system. Ramp down of surgical services led to significant backlogs for time-sensitive scheduled pediatric patients. We designed and implemented a novel pilot weekend surgical quality improvement project called Operating Room Ramp-Up After COVID Lockdown Ends – Extra Lists (ORRACLE-Xtra).
Objective:
Our overall goals were to increase patient access to surgery (and reduce the waitlist), improve operating room efficiencies, and optimize parent and staff experience.
Methods:
Using the DMAIC framework (define, measure, analyze, improve, control), we implemented ORRACLE-Xtra in a tertiary care academic pediatric hospital during a quiescence of the COVID-19 pandemic and defined process and outcome measures based on provincial targets of out of window cases. Parental and staff satisfaction was tracked by surveys.
Results:
ORRACLE-Xtra led to 247 patients receiving surgery during the pilot period resulting in a 5 percent decrease in the total number of patients on our waitlist with P-CATS IV 59.5%, with 38.1% out-of-window of provincial targets. Most of the process and outcome measures were met or exceeded. Overall parental satisfaction was at 95.8% with staff reporting 79.1% satisfaction of working on the weekends.
Results:
ORRACLE-Xtra led to 247 patients receiving surgery during the pilot period resulting in a 5 percent decrease in the total number of patients on our waitlist with P-CATS IV 59.5%, with 38.1% out-of-window of provincial targets. Most of the process and outcome measures were met or exceeded. Overall parental satisfaction was at 95.8% with staff reporting 79.1% satisfaction of working on the weekends.
Conclusions:
Through the ORRACLE-Xtra pilot program, we have shown that hospitals impacted by COVID-19 can reduce the surgical backlog using innovative models of service delivery in a Canadian context. Sustained funding is critical to achieving more meaningful reductions in wait times for scheduled surgeries over the longer term and needs to be balanced with staff well-being. Clinical Trial: N/A
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