Hôpital régional de Sudbury Regional Hospital
Report on
Provincial Wait Time Strategy
May 2007
Provincial Wait-time Strategy
•
Announced by Minister of Health in
November 2004
•
Focus is to increase access and reduce wait
times for five major health services:
1.
2.
3.
4.
5.
Cancer surgery
Cardiac procedures
Cataract surgery
Hip and knee replacements
MRI and CT exams
Provincial Wait-Time Strategy
• Ontario's Wait Time Strategy objectives:
– Significantly increase the number of procedures to
reduce the backlog that has developed over the last
decade
– Invest in new, more efficient technology such as MRI
machines and extending hours of operations
– Standardize best practices for both medical and
administrative functions in order to improve patient
flow and efficiency
– Collect and report accurate and up-to-date data on
wait times to allow better decision making and
increase accountability
Definitions
• Median Wait-Time:
– The point at which half of the patients have
completed surgery or exam. The unit of measure
is days
• Average:
– The average length of time a patient waited for
surgery or their exam. The unit of measure is
days.
• 90% Completed:
– the point at which 90 percent of the patients have
completed surgery or their exam. The unit of
measure is days.
HRSRH Results Summary
Green = Better than All Ontario Hospitals with 20% of the province wait
Yellow = Opportunity to improve or explanation required –20% - 25%
Red = Significant improvement opportunity –greater than 25% above provincial number
•
Unit of Measure = Days
•
Date: Oct/Nov 2006 Wait-time data
Median
Average
90%
Cancer Surgery
20
30
62
Angiography
15
17
28
Angioplasty
14
19
35
Cardiac Surgery
14
24
57
Cataract Surgery
89
88
139
Hip Replacement
142
176
323
Knee Replacement
252
266
479
CT Scans
17
39
124
MRI
49
53
97
Cancer Surgery
Cancer Surgery
Median Wait Time
Average Wait Time
90 % Completed
All Ontario
22
35
78
LHIN 13
19
29
61
HRSRH
20
30
62
Cardiac Procedures
Median Wait Time
Average Wait Time
90 % completed
All Ontario
12
13
26
LHIN 13
14
15
26
HRSRH
15
17
28
All Ontario
4
8
20
LHIN 13
14
19
35
HRSRH
14
19
35
All Ontario
18
22
47
LHIN 13
14
24
57
HRSRH
14
24
57
Cardiac Angiography
Cardiac Angioplasty
Cardiac Surgery
Cataract Surgery
Cataract Surgery
Hospital Name
Median Wait Time Average Wait Time
90 % completed
All Ontario
60
97
209
LIHN 13
92
100
188
HRSRH
89
88
139
Joint Surgery
Joint Replacement Hips
Median Wait Time
All Ontario
Average Wait Time
90 % completed
97
126
278
LIHN 13
130
158
309
HRSRH
142
176
323
Joint Replacement Knees
Median Wait Time
Average Wait Time
90 % completed
All Ontario
127
167
357
LIHN 13
169
216
389
HRSRH
252
266
479
Diagnostic Procedures
Magnetic Resonance Imaging
Median Wait Time
All Ontario
Average Wait Time
90 % completed within
113
49
113
LIHN 13
22
36
71
HRSRH
49
53
97
Computerized Tomography
Median Wait Time
All Ontario
Average Wait Time
90 % completed within
13
27
70
LIHN 13
8
26
70
HRSRH
17
39
124
CT Scan Wait Times
What has the HRSRH done to improve wait times?
• May 2006, increased CT operations by 2 shifts per weekend to address
call-back costs related to the ER.
• September 2006, received $259,000 (one time funding) to provide an
additional 1038 operational hours of CT service.
• October 2006, added 5 day shifts in addition to weekends. By March
2007, 1050 additional hours were provided.
• Total patients waiting for CT decreased by 26% since implementation of
additional hours in October.
• Still a lag between implementation of additional time and decrease in the
90% wait. Acutely ill patients move forward much more quickly than
elective patients which impacts median figures.
• For example, January data indicates improvement in median days to 12
(30% improvement) while the 90% is only down to 120 days. This will
improve further as the queue is addressed over the coming months.
Wait-time Volumes
• 2007/08 Wait Time Funding
– Joints: 185
– Cataracts: 600
– Cancer Surgery: 90
– MRI 1248 hours
– CT 830 hours
• End of Fiscal Year 2006/07
– 81/ 124 funded joints 30 transferred to SSM
– 239/260 4810 incremental cataracts
– Cancer 69/90
– Achieved MRI and CT additional hours
Surgical Wait-time Strategy
• Involved physicians
• Established a Surgical Efficiency Team
• Reallocated addition OR time to complete funded
incremental surgical volumes
• Enhancements to ophthalmology staffing –additional
instrumentation –equipment on purchase
• Proposal submitted to LHIN Nov 2006 funding letter
received March 13, 2007 to be spent March 31, 2007
• Pilot to protect all orthopaedic surgical beds currently in
process
Critical Care Capacity
• Six new critical care beds
• Critical Care Response Teams
• Intensivist Management Critical Care
• Critical Care Information Management System
• High Cost Intervention Project
• Additional Nursing Training Funding for Nurses
• E-Learning Strategy and Clinical Simulation
Challenges - Capacity
•
Operating Room Capacity
•
Physician Manpower
–
–
–
–
–
Anaesthesiology (critical care strategy)
•
Anaesthesiology Teams
Surgeons
Surgical assistants RNFA
Hours of work
Nursing Capacity
•
Inpatient Bed Capacity
•
Alternative Level of Care
•
–
–
Long Term Care
Hospital convalescent and rehabilitation
Community Service Capacity