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. Cancer surgery 2. Cardiac procedures 3. Cataract surgery 4. Hip and knee replacements 5. 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.
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 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 22 35 78 LHIN 13 19 29 61 20 30 62
Cardiac Procedures Median Wait Time Average Wait Time 90 % completed Cardiac Angiography 12 13 26 LHIN 13 14 15 26 15 17 28 Cardiac Angioplasty 4 8 20 LHIN 13 14 19 35 14 19 35 Cardiac Surgery 18 22 47 LHIN 13 14 24 57 14 24 57
Cataract Surgery Cataract Surgery Hospital Name Median Wait Time Average Wait Time 90 % completed 60 97 209 LIHN 13 92 100 188 89 88 139
Joint Surgery Joint Replacement Hips Median Wait Time Average Wait Time 90 % completed 97 126 278 LIHN 13 130 158 309 142 176 323 Joint Replacement Knees Median Wait Time Average Wait Time 90 % completed 127 167 357 LIHN 13 169 216 389 252 266 479
Diagnostic Procedures Magnetic Resonance Imaging Median Wait Time Average Wait Time 90 % completed within 113 49 113 LIHN 13 22 36 71 49 53 97 Computerized Tomography Median Wait Time Average Wait Time 90 % completed within 13 27 70 LIHN 13 8 26 70 17 39 124
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.
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