A systematic literature review on the utilization of extended operating room hours to reduce surgical backlogs

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'.

Introduction

Hospital managers address elective patient surgical backlogs with different strategies: increasing installed capacity, managing demand and improving efficiency. Recently, and particularly since the COVID-19 elective surgery suspension, extended operating room hours has been used to reduce waiting lists by taking advantage of empty operating rooms and existing surgical teams.

Methods

Two research questions are raised: (1) which are the scientific literature's insights related to the use of extended operating room hours to help reduce surgery backlogs? and (2) provided that a hospital decides to extend its operating room opening time, what are the main challenges and the key aspects to consider in the design and implementation of policies to manage extended operating room hours? A systematic review on Web of Science database was conducted to gather existing literature, published from January 2012 to December 2021, regarding strategies to reduce waiting lists using empty operating rooms outside regular working hours.

Results

A total of 12 papers were selected as relevant to address the two research questions. Results were organized according to their main features, namely setting, type of strategy, methodology, and how human resources are handled.

Discussion

The review suggests that extended operating room hours might be problematic if current staff is used and that a careful choice of patients should be made. However, its potential to reduce waiting times and its implications are discussed only superficially. Therefore, we analyze the implications of extending operating room hours from four different perspectives (management, staff, patients, and strategy deployment) and define some recommendations for policy makers and healthcare managers when implementing it in practice.

Healthcare Providers and Caregivers' Perspectives on the Quality of Child Health Services in Urban Indonesia: A Mixed-Methods Study

Although Indonesia’s child mortality rate has decreased in tandem with the global trend, healthcare services can be further improved for children. This study aims to explore the perceptions of healthcare providers and caregivers of children aged below five years to improve child health in urban Indonesia. A mixed-methods study design was adopted. Quantitative data were collected via questionnaires from the caregivers. Qualitative data were collected via semi-structured interviews from the healthcare providers. Analysis of 540 caregiver questionnaires regarding the care provided to their child revealed that the majority of them were very satisfied (46.1%) and satisfied (52.2%) with the care received. Analysis of 12 interviews with healthcare providers derived three major themes: (1) importance of one’s role as a healthcare provider; (2) factors affecting the delivery of healthcare; and (3) the way forward in caring for young children. Although caregivers were very satisfied with the care received for their children, the perception of healthcare providers regarding their responsibility in delivering care to children under five years old provides insights into improving the quality of services for children in Indonesia. Our findings suggest that mortality and morbidity of children aged below five years can be best reduced by optimizing primary and secondary preventive measures.