# A Feasibility Study on Conducting Elective Surgeries During Weekends and Evening Hours in a Public Hospital in Riyadh, Saudi Arabia

## TL;DR

This study shows that elective surgeries performed during evenings and weekends in a Saudi hospital are safe and efficient.

## Contribution

The study demonstrates the feasibility and safety of extending elective surgery hours beyond traditional times in a public hospital setting.

## Key findings

- 30% of elective surgeries were conducted during extended hours (weekends and evenings) in 2024.
- No deaths occurred among weekend elective surgeries, compared to a 0.12% mortality rate for weekday surgeries.
- Only one unplanned return to the OR occurred, and it was during weekday surgeries.

## Abstract

Background: The working schedule for operating rooms (ORs) in public hospitals in Saudi Arabia spans five days a week, with eight working hours per day. However, to meet the surgical needs of our beneficiaries, we extended the elective operating room schedule by adding extra slots during evenings and weekends.

Methods: This is a retrospective analysis of elective surgical cases conducted at King Salman Hospital, Riyadh, from January 2024 to December 2024. The cases were categorized into two main groups: those conducted during the routine weekday schedule and those performed during the extended list (weekends and evenings). Unplanned return to the operating room within 24 hours of the primary procedure and 30-day mortality were identified as the main outcome measures. Chi-square and Fisher's exact tests were applied to test the statistical significance between the two groups.

Results: During 2024, a total of 5024 routine surgeries were performed at our hospital, of which 30% (1550/5024) were conducted during extended hours: 21% (1080/5024) during weekends and 9% (470/5024) during evening hours. Of the total cases conducted during the extended list, about 78% (1206/1550) were day surgeries, while about 40% (625/1550) were major in complexity. The mortality rate for weekday elective surgeries was observed to be 0.12% (4/3474), while there were no deaths among weekend elective surgeries (p < 0.001). There was only one case of unplanned return to the OR, which occurred during the main weekday OR list.

Conclusion: Performing elective surgeries during nontraditional working hours is a safe and efficient approach to maximize hospital resources.