– The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months.
– The research design is a multiple cases study. The paper selected three cases: Case 1 – staff were able to maintain compliance with requirements for more than 18 months; Case 2 – staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 – staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools.
– Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit.
– The authors’ research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.
