Ajustando a consulta com várias junções

Eu tenho esta consulta .. 214 Execução / min, 44,42 CPU média (ms) existe uma maneira de torná-lo muito mais rápido

SELECT        P.Id id0,
              P.ProgramId ProgramId1,
              P.ProgramName ProgramName2,
              P.ProgramLevel ProgramLevel3,
              P.Department Department4,
              P.Track Track5,
              P.AcademicYear AcademicYear6,
              P.StartTerm StartTerm7,
              P.Delivery Delivery8,
              P.Fee Fee9,
              P.City City10,
              P.STATE State11,
              P.StartDate StartDate12,
              P.Deadline Deadline13,
              P.DeadlineDisplay DeadlineDisplay14,
              P.ProgramType ProgramType15,
              O.Id as OrganizationId16,
              O.NAME OrganizationName17,
              P.ApplicationType ApplicationType18,
              P.Concentration Concentration19,
              P.ZipCode ZipCode20,
              P.Campus Campus21,
              P.WADisplayName WADisplayName22,
              P.UpdatedDate updateDate23,
              AF.Id InstanceId24,
              RD.Id stateId33
INTO #TempGetFullProgramSelectionInfo            
FROM    unicas_config..applicationForm AF  
  INNER JOIN UNICAS_CONFIG.. AcademicInstitution AI
           ON AF.casid=AI.casid 
  INNER JOIN UNICAS_CONFIG..Organization O 
           ON O.academicInstitutionid=AI.id   
  INNER JOIN UNICAS_CONFIG..AssociationOrg asOrg
           ON asOrg.FormId=AF.id
  INNER JOIN  UNICAS_CONFIG..Program P
           ON P.AssociationOrgId=asOrg.Id and asOrg.OrganizationId=O.id AND AF.Id = 6286
  INNER JOIN  unicas_config..ReferenceData RD 
                 ON P.STATE = RD.ValueId AND RD.ValueAbbr ='US'
  INNER JOIN  unicas_config..ReferenceDataSet RS  
           ON RD.ReferenceSetId = RS.SetId AND RS.NAME = 'LK_States'

Agora isso se eu dividir para 2 consultas

select RD.ValueId, RD.id into #temp1
from   unicas_config..ReferenceData RD
INNER JOIN  unicas_config..ReferenceDataSet RS   ON RD.ReferenceSetId= RS.SetId AND RS.NAME= 'LK_States'
where RD.ValueAbbr='US';


SELECT        P.Id id0,
              P.ProgramId ProgramId1,
              P.ProgramName ProgramName2,
              P.ProgramLevel ProgramLevel3,
              P.Department Department4,
              P.Track Track5,
              P.AcademicYear AcademicYear6,
              P.StartTerm StartTerm7,
              P.Delivery Delivery8,
              P.Fee Fee9,
              P.City City10,
              P.STATE State11,
              P.StartDate StartDate12,
              P.Deadline Deadline13,
              P.DeadlineDisplay DeadlineDisplay14,
              P.ProgramType ProgramType15,
              O.Id as OrganizationId16,
              O.NAME OrganizationName17,
              P.ApplicationType ApplicationType18,
              P.Concentration Concentration19,
              P.ZipCode ZipCode20,
              P.Campus Campus21,
              P.WADisplayName WADisplayName22,
              P.UpdatedDate updateDate23,
              AF.Id InstanceId24,
              RD.Id stateId33
INTO #TempGetFullProgramSelectionInfo            
FROM    unicas_config..applicationForm AF  
  INNER JOIN UNICAS_CONFIG.. AcademicInstitution AI
           ON AF.casid=AI.casid 
  INNER JOIN UNICAS_CONFIG..Organization O 
           ON O.academicInstitutionid=AI.id   
  INNER JOIN UNICAS_CONFIG..AssociationOrg asOrg
           ON asOrg.FormId=AF.id
  INNER JOIN  UNICAS_CONFIG..Program P
           ON P.AssociationOrgId=asOrg.Id and asOrg.OrganizationId=O.id AND AF.Id = 6286
  INNER JOIN    #temp1 RD ON P.STATE= RD.ValueId;

usando a consulta recomendada pelo Frisbee

Usando junção Hash

Faça uma tentativa
Você tem algumas (potencialmente) condições de junção equivocadas

SELECT        P.Id id0,
              P.ProgramId ProgramId1,
              P.ProgramName ProgramName2,
              P.ProgramLevel ProgramLevel3,
              P.Department Department4,
              P.Track Track5,
              P.AcademicYear AcademicYear6,
              P.StartTerm StartTerm7,
              P.Delivery Delivery8,
              P.Fee Fee9,
              P.City City10,
              P.STATE State11,
              P.StartDate StartDate12,
              P.Deadline Deadline13,
              P.DeadlineDisplay DeadlineDisplay14,
              P.ProgramType ProgramType15,
              O.Id as OrganizationId16,
              O.NAME OrganizationName17,
              P.ApplicationType ApplicationType18,
              P.Concentration Concentration19,
              P.ZipCode ZipCode20,
              P.Campus Campus21,
              P.WADisplayName WADisplayName22,
              P.UpdatedDate updateDate23,
              AF.Id InstanceId24,
              RD.Id stateId33
INTO #TempGetFullProgramSelectionInfo            
FROM       UNICAS_CONFIG..Organization O                 
INNER JOIN UNICAS_CONFIG..AcademicInstitution AI
            ON AI.id = O.academicInstitutionid        
INNER JOIN unicas_config..applicationForm AF
            ON AF.casid = AI.casid  
           AND AF.Id = 6286   
INNER JOIN UNICAS_CONFIG..AssociationOrg asOrg
            ON asOrg.FormId         = AF.id
           and asOrg.OrganizationId = O.id
INNER JOIN UNICAS_CONFIG..Program P
            ON P.AssociationOrgId = asOrg.Id 
INNER JOIN unicas_config..ReferenceData RD 
            ON RD.ValueId = P.STATE  
           AND RD.ValueAbbr ='US'
INNER JOIN unicas_config..ReferenceDataSet RS  
            ON RS.SetId = RD.ReferenceSetId   
           AND RS.NAME = 'LK_States'

Se #temp tiver índices, escolha o que faz mais sentido

Se isso não melhorar a resposta, basta forçar uma junção de hash em todos.
Ainda use o select na minha resposta - adicione o HASH à consulta acima

INNER HASH JOIN

Tente criar o seguinte índice (supondo que ele ainda não exista)

CREATE INDEX ix_Organization_academicInstitutionid
    ON Organization(academicInstitutionid, Id) INCLUDE (Name)

Antes de fazer qualquer alteração no script, basta executar um índice refutado em todas as tabelas envolvidas e ver se há algum aumento significativo. (pelo menos, reconstrua as estatísticas no nível da tabela com varredura completa)

[Program] parece uma tabela grande, verifique se P.AssociationOrgId está indexado.