SRS180 - Addressing delays in post-operative X-rays in hip replacement surgery: a quality improvement project

Background Post-operative X-rays are essential for assessing outcomes after hip replacement surgery, but compliance with timely imaging protocols varies. This quality improvement project sought to facilitate the prompt acquisition of post-operative X-rays for trauma patients undergoing hip replacement surgery. Methods We conducted a quality improvement project using Plan-Do-Study-Act methodology over three iterative cycles between April 2024 and March 2025. Cycle 1 established baseline performance through retrospective review of 100 consecutive patients. Cycle 2 prospectively evaluated implementation of targeted interventions across all 55 eligible patients over a six-week period. Cycle 3 assessed sustainability through retrospective analysis of all 150 eligible patients without staff awareness of monitoring. Data collected included time from surgery to X-ray request, request quality, and time to X-ray acquisition. Results Baseline assessment showed 74 % of X-rays were requested on surgery day, however only 50% performed within one day post-operatively. After implementing interventions, Cycle 3 demonstrated significant improvements: 73% of requests submitted within one hour of surgery, average request time decreased from 12.3 to 5.8 h, and time from surgery to X-ray reduced from 44 to 35.6 h. The percentage of X-rays performed within one day increased from 50 to 65%. Conclusions A structured quality improvement approach successfully improved the timeliness of post-operative X-rays despite external constraints such as staffing variability and seasonal pressures. Sustainability requires robust protocols, educational tools and addressing resource limitations, particularly patient transport equipment.