Report on Provincial Wait Time Strategy

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Lawrence Campbell
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1 Hôpital régional de Sudbury Regional Hospital Report on Provincial Wait Time Strategy May 2007

2 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. Cancer surgery 2. Cardiac procedures 3. Cataract surgery 4. Hip and knee replacements 5. MRI and CT exams

3 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

4 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.

5 Results Summary Green = Better than 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 Angiography Angioplasty Cardiac Surgery Cataract Surgery Hip Replacement Knee Replacement CT Scans MRI

6 Cancer Surgery Cancer Surgery Median Wait Time Average Wait Time 90 % Completed LHIN

7 Cardiac Procedures Median Wait Time Average Wait Time 90 % completed Cardiac Angiography LHIN Cardiac Angioplasty LHIN Cardiac Surgery LHIN

8 Cataract Surgery Cataract Surgery Hospital Name Median Wait Time Average Wait Time 90 % completed LIHN

9 Joint Surgery Joint Replacement Hips Median Wait Time Average Wait Time 90 % completed LIHN Joint Replacement Knees Median Wait Time Average Wait Time 90 % completed LIHN

10 Diagnostic Procedures Magnetic Resonance Imaging Median Wait Time Average Wait Time 90 % completed within LIHN Computerized Tomography Median Wait Time Average Wait Time 90 % completed within LIHN

11 CT Scan Wait Times What has the 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.

12 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/ incremental cataracts Cancer 69/90 Achieved MRI and CT additional hours

13 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

14 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

15 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

A Report to the City of Greater Sudbury Mayor and Council. Hôpital régional de Sudbury Regional Hospital

A Report to the City of Greater Sudbury Mayor and Council Hôpital régional de Sudbury Regional Hospital Local Health Integration Networks Most fundamental change we will see within our health care system