Implementation challenges for an optimised surgery blueprint schedule in a children's hospital: an exploratory qualitative study using the CFIR framework

Capacity management and planning for operating theatres involves scheduling surgeries, preparing beds, and ensuring available workforce. Numerous mathematical models have been developed in the scientific literature to optimise these schedules to aid planning decisions, but such models are rarely assessed for applicability and implementation within a hospitals existing planning system. We address this implementation research gap by identifying the barriers and facilitators for adopting a mathematically optimised surgery blueprint schedule within a childrens hospital, using the Consolidated Framework for Implementation Research (CFIR). Facilitators for implementation of the schedule included a strong motivation among staff to optimise schedules given resource constraints and work burdens, as well as positive reactions towards an objectively designed mathematical scheduling tool. Barriers for implementation included a resistance to change among some staff, and the need for more evidence about the new schedules benefits before implementation. We identified a strong culture of operational adjustments made to schedules, which is a challenge to any optimised and centralised scheduling tool. Overall, we found that CFIR was a helpful tool for identifying specific innovation adoption factors for a proposed surgery scheduling model.