Reducing Elective Surgery Backlogs Through Centralized Waiting List Management: A Quality Improvement Study.

Introduction: Growing elective surgical waiting lists remain a persistent global challenge, exacerbated by the COVID-19 pandemic, which led to the widespread suspension of non-urgent procedures. In the Gulf region, elective surgery cancellation rates reached up to 72% by 2020, compounding surgical b...

Full description

Bibliographic Details
Published in:Inquiry (00469580) Vol. 63; pp. 1 - 2
Main Authors: Daoud, Rabbani Mahmoud, Alhoda, Moosa, Jasim, Zainab, Fredericks, Salim, Kause, Juliane
Format: Article
Published: Sage Publications Inc. 5/5/2026
Subjects:
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=hlh&AN=193525786&site=ehost-live
header:
  @attributes:
    shortDbName: hlh
    uiTerm: 193525786
    longDbName: Humanities International Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    jinfo:
      jid:
        00469580
        INQ
      jtl: Inquiry (00469580)
      issn: 00469580
      maglogo: Y
    pubinfo:
      dt: 5/5/2026
      vid: 63
      pid: 344
      pub: Sage Publications Inc.
    artinfo:
      ui:
        193525786
        10.1177/00469580261449124
      ppf: 1
      ppct: 1
      formats:
      tig:
        atl: Reducing Elective Surgery Backlogs Through Centralized Waiting List Management: A Quality Improvement Study.
      aug:
        au:
          Daoud, Rabbani Mahmoud
          Alhoda, Moosa
          Jasim, Zainab
          Fredericks, Salim
          Kause, Juliane
        affil:
          Department of Internal Medicine, Hull University Teaching Hospital, Hull, UK
          Department of Health Sciences, University of York, York, UK
          Department of Internal Medicine, Mass General Brigham Salem Hospital, Massachusetts, USA
          Department of Simulation, Royal College of Surgeons in Ireland, Muharraq, Bahrain
          Department of Internal Medicine, Salmaniya Medical Complex, Manama, Bahrain
          Department of Biochemistry, Royal College of Surgeons in Ireland, Muharraq, Bahrain
          CEO Advisor of Government Hospitals in Bahrain, Salmaniya Medical Complex, Manama, Bahrain
          Department of Medicine, Royal College of Surgeons in Ireland, Muharraq, Bahrain
      su:
        Medical care use
        Public hospitals
        Urology
        Health services accessibility
        Health services administration
        Data analysis
        T-test (Statistics)
        Medical quality control
        Sex distribution
        Medical care
        Retrospective studies
        Tertiary care
        Descriptive statistics
        Age distribution
        Endoscopic surgery
        Pre-tests & post-tests
        Ophthalmology
        Orthopedics
        Workflow
        Elective surgery
        Medical appointments
        Medical records
        Acquisition of data
        Patient-professional relations
        Electronic health records
        Communication
        Quality assurance
        Automation
        Data analysis software
        COVID-19 pandemic
        Medical referrals
        Nonparametric statistics
        Endoscopy
        Bahrain
      sug:
        subj:
          Bahrain
          Medical care use
          Public hospitals
          Urology
          Health services accessibility
          Health services administration
          Data analysis
          T-test (Statistics)
          Medical quality control
          Sex distribution
          Medical care
          Retrospective studies
          Tertiary care
          Descriptive statistics
          Age distribution
          Endoscopic surgery
          Pre-tests & post-tests
          Ophthalmology
          Orthopedics
          Workflow
          Elective surgery
          Medical appointments
          Medical records
          Acquisition of data
          Patient-professional relations
          Electronic health records
          Communication
          Quality assurance
          Automation
          Data analysis software
          COVID-19 pandemic
          Medical referrals
          Nonparametric statistics
          Endoscopy
      keyword:
        COVID-19
        elective surgery backlog
        electronic patient record
        healthcare quality assurance
        operating rooms
        quality improvement
        surgical waiting time
        time to treatment
        waiting lists
      ab: Introduction: Growing elective surgical waiting lists remain a persistent global challenge, exacerbated by the COVID-19 pandemic, which led to the widespread suspension of non-urgent procedures. In the Gulf region, elective surgery cancellation rates reached up to 72% by 2020, compounding surgical backlogs. At Salmaniya Medical Complex, Bahrain's largest public tertiary hospital, the resulting backlog overwhelmed existing systems that relied on fragmented spreadsheets and manual logs. This Quality Improvement Project (QIP) aimed to improve surgical waiting list management using a centralized, data-driven approach to reduce backlog, improve scheduling, and enhance theatre utilization. Methods: This retrospective pre-post QIP included all adult patients (≥18 years) listed for elective, non-cancer surgery across secondary and tertiary surgical specialties between January 2019 and December 2023. Interventions, implemented from January to August 2024, included: (1) consolidating all waiting list data into a single computerized system; (2) validating and updating entries through direct patient contact; and (3) integrating a centralized repository within the Electronic Patient Record (EPR) system. This enabled real-time tracking, automated prioritization, and flexible scheduling. The primary outcome was waiting list volume. Secondary outcomes were mean waiting time to surgery and theatre utilization. Descriptive statistics and paired t-tests were applied to assess the significance of any differences observed with a significance of p<0.05. Results: From January to August 2024, the surgical waiting list decreased by 51.74%, from 9,597 to 4,627 patients. Major reductions (relative to the baseline waiting list) were observed in Ophthalmology (69.40%), Urology (59.23%), and Orthopedics (58.59%). Mean waiting times (SD) decreased from 12.7 (7.72) to 7.2 (4.75) months (p = 0.014), corresponding to a 158-day reduction. Mean monthly caseload in the main operating theatres (MOT) increased from 1,469 (139.3) cases in 2023 to 1,608 (94.4) in 2024 (p < 0.001). Conclusion: A centralized, EPR-integrated surgical waiting list system significantly reduced surgical backlogs and delays, while improving coordination, prioritization, and theatre utilization. Differences in outcomes across departments reflect varying case complexities and highlight the need for tailored strategies. This scalable model supports more efficient post-pandemic recovery and long-term service resilience.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
    refInfo:
    copyright:
      @attributes:
        flag: Y
      dt:
        @attributes:
          year: 2026
    holdings:
      @attributes:
        islocal: N