ArticleJMIR perioperative medicine2022
A Canadian Weekend Elective Pediatric Surgery Program to Reduce the COVID-19-Related Backlog: Operating Room Ramp-Up After COVID-19 Lockdown Ends-Extra Lists (ORRACLE-Xtra) Implementation Study.
Article in JMIR perioperative medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Strategies to strengthen elective surgery systems during the SARS-CoV-2 pandemic: systematic review and framework development.The British journal of surgery · 2024Pooled it
- Pediatric Preanesthesia Assessment Electronic Triage Tool: Implementation, Quality Improvement, and Retrospective Observational Evaluation of a Patient-Administered Questionnaire.Paediatric anaesthesia · 2026Observational
- Impact of COVID-19 pandemic on elective care backlog trends, recovery efforts, and capacity needs to address backlogs in Scotland (2013-2023): a descriptive analysis and modelling study.The Lancet regional health. Europe · 2025Article
- Article
- Trends and Outcomes in Elective Pediatric Surgery During Weekends.Journal of pediatric surgery · 2025Article
- Developing a Cost-Effective Surgical Scheduling System Applying Lean Thinking and Toyota's Methods for Surgery-Related Big Data for Improved Data Use in Hospitals: User-Centered Design Approach.JMIR formative research · 2024Article
- Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies.Healthcare (Basel, Switzerland) · 2023Article
- Patient and Process Outcomes among Pediatric Patients Undergoing Appendectomy during the COVID-19 Pandemic: An International Retrospective Cohort Study.Anesthesiology · 2023Article
- The impact of the COVID-19 pandemic on the perioperative transition to specialty practice program.Journal of advanced nursing · 2023Article
- Experiences of Health Care Professionals Working Extra Weekends to Reduce COVID-19-Related Surgical Backlog: Cross-sectional Study.JMIR perioperative medicine · 2022Article
- Impact of COVID-19 on Society of Urologic Oncology fellowship operative volumes.Urologic oncology · 2022Article
- Article
- Revisiting the concept of urgency in surgical prioritization and addressing backlogs in elective surgery provision.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe COVID-19 pandemic caused by the SARS-COV-2 virus has resulted in unprecedented challenges for the health care system. A decrease of surgical services led to substantial 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).
objectiveOur overall goals are to increase patient access to surgery (and reduce the wait list), improve operating room efficiencies, and optimize parent and staff experience.
methodsUsing the DMAIC (define, measure, analyze, improve, control) framework, we implemented ORRACLE-Xtra in a tertiary care academic pediatric hospital during a quiescent period of the COVID-19 pandemic. We defined process and outcome measures based on provincial targets of out-of-window cases. Parental and staff satisfaction was tracked by surveys.
resultsORRACLE-Xtra led to 247 patients receiving surgery during the pilot period, resulting in a 5% decrease in the total number of patients on our wait list with Paediatric Canadian Access Targets for Surgery IV (147/247, 59.5%), with 38.1% (94/247) out-of-window of provincial targets. Most of the process and outcome measures were met or exceeded. Overall parental satisfaction was at 95.8% (110/121), with 79% (64/81) of staff reporting satisfaction with working weekends.
conclusionsThrough 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.
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