The Saudi Journal of Health Systems Research · Published 2026-06-30 · DOI 10.1159/000553339
Hadi Al Ali, Abdulmajeed Al-Musma, Ibrahim Alshahrani, Hamzah Asiri, Sarah Asiri, Bandar Al Qahtani, Ghalib Alsayed, Mohamed Safan, Ahmad Alasmari, Noha Saleh Hassanien
Background Long surgical waiting times are a major healthcare problem worldwide because they decrease patient satisfaction and drain resources. Thus, their reduction has become the focus of our research. Furthermore, we aimed to propose strategies to ensure that multiphase interventions are implemented at different stages for more promising outcomes. Methods This longitudinal sequential study with interrupted time series analysis was conducted at the Armed Forces Hospital of the South Region, Saudi Arabia, between 2021 and 2024. Multidisciplinary interventions were implemented, with reduced waiting times for elective surgeries as the primary endpoint. In Phase I, resources were reorganized and optimized; Phase II prioritized increasing supply; and Phase III aimed to stratify patients at the pre-admission clinic. The financial impacts were also assessed. Results: The organizational restructuring intervention led to a statistically significant and immediate reduction in surgical waiting time (p < .001) with a borderline significant sustained improvement in the post-intervention trend (p = .053). Surgical capacity increased (71.4%); the total number of performed surgeries increased from 10,677 to 13,863 (77%); and the usage rate of operating rooms (ORs) increased from 56% to 86%. In contrast, both the second and the third interventions, which focused on increasing supply and establishing a pre-admission clinic, had a non-significant effect on the reduction of waiting times (p = .440 and p = 0.931, respectively). The cancellation rate declined from 8% to 6% in the third intervention. There was a cost savings due to the reduction of the idle costs of unused resources. Conclusion System change intervention was highly effective in the reduction of waiting time for elective surgery in addition to its sustained impact, while increasing supply without systemic reform may be insufficient. Pre-admission clinics showed a non-significant impact on waiting times. Those multiple interventions led to cost savings.
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Ali, H., Al-Musma, A., Alshahrani, I., et al. (2026). Sequential Impact of multiphase interventions for reduction of surgical waiting times: A longitudinal study at Armed Forces Hospital of South Region, Saudi Arabia. The Saudi Journal of Health Systems Research. https://doi.org/10.1159/000553339