BACKGROUND: Delay to surgery for @entity1 with @entity173 is associated with higher incidence of @entity532 , prolonged recovery and length of stay, and increased mortality. Therefore, many health care organisations launch improvement programmes to reduce the wait for surgery. The heterogeneous application of similar methods, and the multifaceted nature of the interventions, constrain the understanding of which method works, when, and how. In complex acute care settings, another concern is how changes for one @entity1 group influence the care for other groups. We therefore set out to analyse how multiple components of @entity173 improvement efforts aimed to reduce the time to surgery influenced that time both for @entity173 @entity1 and for other acute surgical orthopaedic inpatients. METHODS: This study is an observational mixed-methods single case study of improvement efforts at a Swedish acute care hospital, which triangulates control chart analysis of process performance data over a five year period with interview, document, and non- @entity1 observation data. RESULTS: The improvement efforts led to an increase in the monthly percentage of @entity173 @entity1 operated within 24  h of admission from an average of 47  % to 83  %, with performance predictably ranging between 67  % and 98  % if the process continues unchanged. Meanwhile, no significant changes in lead time to surgery for other acute surgical orthopaedic inpatients were observed. Interview data indicated that multiple intervention components contributed to making the process more reliable. The triangulation of qualitative and quantitative data, however, indicated that key changes that improved performance were the creation of a process improvement team and having an experienced clinician coordinate demand and supply of surgical services daily and enhance pre-operative @entity1 preparation. CONCLUSIONS: Timeliness of surgery for @entity1 with @entity173 in a complex hospital setting can be substantially improved without displacing other @entity1 groups, by involving staff in improvement efforts and actively managing acute surgical procedures.

Unpacking the key components of a programme to improve the timeliness of XXXX care: a mixed-methods case study.

@entity1 :: ('9606', 'Species') :: ['patients', 'participant', 'patient'] @entity173 :: ('MESH:D006620', 'Disease') :: ['hip-fracture', 'hip fracture'] @entity532 :: ('MESH:D003925', 'Disease') :: ['post-operative complications']
@entity173 :: (MESH:D006620,Disease) :: ['hip-fracture']
