Technical Information

Percent of cancer surgery patients whose surgical consult occurs within priority access target for Wait 1

Priority 2 = 10 Days

Priority 3 = 21 Days

Priority 4 = 35 Days

Figures 1, 2, 3 and 4

​Ontario Wait Time Strategy has identified Wait 1 as a critical component of the surgical patient wait time journey in order to provide a more complete and transparent measure of access to surgery

Articles

Boyd, K.U., et al. (2010). Factors Affecting Surgical Wait Times for Breast Reconstruction,

Canadian Journal of Plastic Surgery, 18(3): 107-111

Farrell, S. (2008). Statement on Wait Times in Obstetrics and Gynaecology, Journal of Obstetrics and Gynaecology Canada, 204:

Gaudet, M., et al. (2007) The Wait for Total Hip Replacement in Patients with Osteoarthritis, Canadian Journal of Surgery, 52(2) 101-109

Glynn, P.A.R., et al. (2003). The Saskatchewan Surgical Care Network- Toward Timely and

Appropriate Access. Hospital Quarterly, 7(1) 44-48

Hurlbert, J., Mobbs, R., Teo, Charles. (2008). Access to Spine Care: A Tale of Two Cities. Canadian Journal of Neurological Sciences, 30(3): 248-257

Milliken, D., et al. (2006). Waiting Too Long: Reducing and Better Managing Wait Times in BC. British Columbia Medical Association, 1-26

Naylor, D., et al. (1995) Waiting for Coronary Artery Bypass Surgery: Population-Based Study of 8517 Consecutive patients in Ontario, Canada, The Lancet, 356: 1605-1609

Sanmartin, C., et al. (2011). Waiting for Medical Services in Canada: Lots of Heat, But Little Light. Canadian Medical Association Journal, 162(9): 1305-1310

Shortt, S.E.D., Shaw, R.A. (2003). Equity in Canadian Health Care: Does Socioeconomic Status Affect Waiting Times for Elective Surgery? Canadian Medical Association Journal, 168(4): 413-416

Simon, D., et al. (2009). Potential Triaging of Referrals for Lumbar Spinal Surgery Consultation: A Comparison of Referral Accuracy from Pain Specialists, Findings from Advanced Imaging and a 3-Item Questionnaire. Canadian Journal of Surgery, 52(6): 473-480

Snider, M.G., et al. (2005). Waiting Times and Patient Perspectives for Total Hip and Knee

Arthroplasty in Rural and Urban Ontario. Canadian Journal of Surgery, 48(5): 355-360

Rumble, T., Kreder, H.J. (2005). Report on Benchmarks for Wait Times. The National Standards Committee Canadian Orthopaedic Association, 1-15

Wright, J.G., Li, K., Seguin, C., Booth, M., Fitzgerald, P., Jones, S., Leitch, K. K., & Willis, B.

(2011). Development of pediatric wait time access targets. Canadian Journal of Surgery, 54 (2):107-110.

Web

http://www.albertahealthservices.ca/4328.asp

http://www.albertahealthservices.ca/org/ahs-org-pr-performance-report.pdf

http://www.cbc.ca/news/health/story/12/06/wait-times-fraser-institute.html

http://www.ccyhc.org/work_surgical_projects.html

http://www.cfhi-fcass.ca/Libraries/TQ2013/Mark-Wyatt-Ron-Epp-presentation.sflb.ashx

https://secure.cihi.ca/free_products/WaitTimesSummary2012_EN.pdf

http://www.fraserinstitute.org/research-news/news/display.aspx?id=
17069

http://www.gov.mb.ca/health/waittime/index.html

http://www.gov.mb.ca/health/waittime/report2006.pdf

http://www.health.alberta.ca/documents/Becoming-the-Best-
2010.pdf

http://www.health.gov.bc.ca/library/publications/year/2009/
Access_to_surgery_SAC_Final_Report.pdf

http://www.health.gov.bc.ca/swt/overview/waittime_targets.html

http://www.health.gov.sk.ca/surgical-initiative

http://www.sasksurgery.ca/

http://www.sasksurgery.ca/cs-waittimes-lists.htm

http://www.waittimealliance.ca/waittimes/P-CATS-Report_en.pdf

http://waittimes.alberta.ca/

http://www.oecd.org/health/waitingtimepolicies.htm

http://www.smh.com.au/national/health/fouryear-surgery-
wait-20130602-2nk22.html#ixzz2gmM9bEpb/

http://www.federalfinancialrelations.gov.au/content/npa/health_
reform/national-workforcereform/national_partnership.pdf

http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129
542732

http://www.nhs.uk/choiceintheNHS/Rightsandpledges/Waitingtimes/
Pages/Guide%20to%20waiting%20times.aspx

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/
Content/Expert-PanelReport#.UPyskm-yBjQ

Legislation

Report to the Council of Australian Governments (2011) (Expert Panel Review of Elective

Surgery and Expert Panel Review of Elective Surgery and Emergency Access Targets under the

National Partnership Agreement on Improving Public Hospital Services) National Health

Reform, Australian Government

​(Total number of cancer surgery patients who had their first consultation with a specialist within the priority access targets / Total number of cancer surgery patients with referral and consult dates) x 100

N/A

Percentage of cancer surgery patients who had their consultation within priority access target

Wait Time Information System

Ontario Cancer Registry (thyroid cancer only)

Jan-Nov 2016

​Provincial, LHIN of Patient Residence

Denominator = Total number of cancer surgery patients with referral and consult dates after applying inclusion/exclusion criteria

Exclusions:

Individuals <18 years old

Skin – carcinoma, skin – melanoma, and lymphomas

Priority 1 procedures and cases with missing priority

Diagnostic, palliative, and reconstructive cancer procedures

Cases where there is no suspicion of cancer or known cancer

Wait list entries identified by hospitals as data entry errors

Operative episodes that take place outside of a fully equipped operating room

Wait list entries without consult and referral dates (No Referral/Follow up cases)

Inclusion:

Closed (or completed) wait list entries with actual procedure dates within date range.

Total number of cancer surgery patients who had their first consultation with a specialist within the priority access target

The percent of cancer surgery patients seen by specialist within access target is weighted based on volume by wait 1 priority level.

Patient Unavailable Days are deducted from patient wait times: The periods of time between the referral and consult date when the patient is unavailable for a first consultation due to patient-related reason are subtracted from the overall Wait 1.

Guidelines are implemented to ensure the facilities submit their data through WTIS in close to real time at source. A 2-business-day rule has been put in place for opening a wait list entry in the system when the decision for treatment is made, and closing the entry after the procedure is performed. This rule is established to ensure compliance with timely data submissions. Wait 1 data is entered at the time of Decision to Treat. It is possible to allow for an audit trail back to the original source of data in the physician’s office or the hospital scheduling system.

As of January 2016, the wait 1 percent completion rate metric was measured against a separate wait 1 priority level assigned to patients seeking specialist consult.

Percent of cancer surgery patients whose surgical procedure occurs within priority access targets for Wait 2

Priority 2 = 14 Days

Priority 3 = 28 Days

Priority 4 = 84 Days

Figures 5, 6, 7 and 8

​​Ontario’s Wait Time Strategy was developed to improve access to five key health services by reducing wait times for cancer surgery, cardiac procedures, cataract surgery, hip and knee replacement and MRI and CT scans.

Articles

Boyd, K.U., et al. (2010). Factors Affecting Surgical Wait Times for Breast Reconstruction,

Canadian Journal of Plastic Surgery, 18(3): 107-111

Farrell, S. (2008). Statement on Wait Times in Obstetrics and Gynaecology, Journal of Obstetrics and Gynaecology Canada, 204:

Gaudet, M., et al. (2007) The Wait for Total Hip Replacement in Patients with Osteoarthritis, Canadian Journal of Surgery, 52(2) 101-109

Glynn, P.A.R., et al. (2003). The Saskatchewan Surgical Care Network- Toward Timely and

Appropriate Access. Hospital Quarterly, 7(1) 44-48

Hurlbert, J., Mobbs, R., Teo, Charles. (2008). Access to Spine Care: A Tale of Two Cities. Canadian Journal of Neurological Sciences, 30(3): 248-257

 Milliken, D., et al. (2006). Waiting Too Long: Reducing and Better Managing Wait Times in BC. British Columbia Medical Association, 1-26

Naylor, D., et al. (1995) Waiting for Coronary Artery Bypass Surgery: Population-Based Study of 8517 Consecutive patients in Ontario, Canada, The Lancet, 356: 1605-1609

 Sanmartin, C., et al. (2011). Waiting for Medical Services in Canada: Lots of Heat, But Little Light. Canadian Medical Association Journal, 162(9): 1305-1310

Shortt, S.E.D., Shaw, R.A. (2003). Equity in Canadian Health Care: Does Socioeconomic Status Affect Waiting Times for Elective Surgery? Canadian Medical Association Journal, 168(4): 413-416

Simon, D., et al. (2009). Potential Triaging of Referrals for Lumbar Spinal Surgery Consultation: A Comparison of Referral Accuracy from Pain Specialists, Findings from Advanced Imaging and a 3-Item Questionnaire. Canadian Journal of Surgery, 52(6): 473-480

Snider, M.G., et al. (2005). Waiting Times and Patient Perspectives for Total Hip and Knee

Arthroplasty in Rural and Urban Ontario. Canadian Journal of Surgery, 48(5): 355-360

Rumble, T., Kreder, H.J. (2005). Report on Benchmarks for Wait Times. The National Standards Committee Canadian Orthopaedic Association, 1-15

Wright, J.G., Li, K., Seguin, C., Booth, M., Fitzgerald, P., Jones, S., Leitch, K. K., & Willis, B.

(2011). Development of pediatric wait time access targets. Canadian Journal of Surgery, 54 (2):107-110.

Web

http://www.albertahealthservices.ca/4328.asp

http://www.albertahealthservices.ca/org/ahs-org-pr-performance-report.pdf

http://www.cbc.ca/news/health/story/12/06/wait-times-fraser-institute.html

http://www.ccyhc.org/work_surgical_projects.html

http://www.cfhi-fcass.ca/Libraries/TQ2013/Mark-Wyatt-Ron-Epp-presentation.sflb.ashx

https://secure.cihi.ca/free_products/WaitTimesSummary2012_EN.pdf

http://www.fraserinstitute.org/research-news/news/display.aspx?id=
17069

http://www.gov.mb.ca/health/waittime/index.html

http://www.gov.mb.ca/health/waittime/report2006.pdf

http://www.health.alberta.ca/documents/Becoming-the-Best-
2010.pdf

http://www.health.gov.bc.ca/library/publications/year/2009/
Access_to_surgery_SAC_Final_Report.pdf

http://www.health.gov.bc.ca/swt/overview/waittime_targets.html

http://www.health.gov.sk.ca/surgical-initiative

http://www.sasksurgery.ca/

http://www.sasksurgery.ca/cs-waittimes-lists.htm

http://www.waittimealliance.ca/waittimes/P-CATS-Report_en.pdf

http://waittimes.alberta.ca/

http://www.oecd.org/health/waitingtimepolicies.htm

http://www.smh.com.au/national/health/fouryear-surgery-
wait-20130602-2nk22.html#ixzz2gmM9bEpb/

http://www.federalfinancialrelations.gov.au/content/npa/health_
reform/national-workforcereform/national_partnership.pdf

http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129
542732

http://www.nhs.uk/choiceintheNHS/Rightsandpledges/Waitingtimes/
Pages/Guide%20to%20waiting%20times.aspx

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/
Content/Expert-PanelReport#.UPyskm-yBjQ

Legislation

Report to the Council of Australian Governments (2011) (Expert Panel Review of Elective

Surgery and Expert Panel Review of Elective Surgery and Emergency Access Targets under the

National Partnership Agreement on Improving Public Hospital Services) National Health

Reform, Australian Government

​Total number of cancer surgery patients who had their surgical treatment from decision for surgery within the wait 2 priority access targets/ Total number of cancer surgery patients who had their surgical treatment within the reporting period) x 100%

N/A

Percent of cancer surgery patients treated within wait time priority access target

Wait Time Information System,

Ontario Cancer Registry (throid cancer only)

2008 – 2016 (Jan-Nov)

​Provincial, LHIN of Patient Residence

Denominator = Total number of cancer surgery patients who had their surgical treatment within the reporting period after applying inclusion/exclusion criteria

Exclusions:

Individuals <18 years old

Skin – carcinoma, skin – melanoma, and lymphomas

Priority 1 procedures and cases with missing priority

Diagnostic, palliative, and reconstructive cancer procedures

Cases where there is no suspicion of cancer or known cancer

Wait list entries identified by hospitals as data entry errors

Operative episodes that take place outside of a fully equipped operating room

Inclusion:

Closed (or completed) wait list entries with actual procedure dates within date range.

For thyroid cancer surgery wait times, incidence cases from OCR (January 1, 2010 to December 31, 2015) with a valid health card number and an endocrine-classified record in WTIS were included.

Total number of cancer surgery patients who had their surgical treatment from decision for surgery within the wait 2 priority access targets

The percent of cancer surgery patients treated within access target is weighted based on volume by priority level.

Patient Unavailable Days are deducted from patient wait times: The periods of time between the Decision To Treat (DTT) date and the Actual Procedure date when the patient is unavailable for the procedure due to patient-related reasons are subtracted from the overall Wait 2.

Guidelines are implemented to ensure the facilities submit their data through WTIS in close to real time at source. A 2-business-day rule has been put in place for opening a wait list entry in the system when the decision for treatment is made, and closing the entry after the procedure is performed. This rule is established to ensure compliance with timely data submissions. Wait 1 data is entered at the time of Decision to Treat. It is possible to allow for an audit trail back to the original source of data in the physician’s office or the hospital scheduling system