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Tuesday, October 25, 2005
 Ron
Saddington, TBRHSC President and CEO,
reported that Thunder Bay Regional Health Sciences Centre
is performing better than the surgical oncology median wait
time standard and is performing well when it comes to Cancer
Surgery Wait Times.
Right now, the MOHLTC
web site provides a “snap shot” of one point
in time, July, 2005. The median wait time demonstrates the
point at which 50% of the patients have completed their surgery.
This reflects what a typical patient might experience in that
period of time.
Our Health Sciences Centre is working with our surgeons to
examine the wait time data, and, more importantly, address
the urgency of surgeries. Cancer surgeries are always prioritized.
The MOHLTC will need to assess the quality of the data provided
on a go-forward basis. That is why, for example, with the
MRI data, we will see improvements because a second MRI was
recently installed. Since August, our patients have been moving
through the queue more quickly. Obviously, this data was not
evident in the initial MOHLTC “snapshot”. Therefore,
the “snapshot” is out-of-date as it relates to
TBRHSC on this issue.
It is clearly understood among healthcare providers that
a long wait time does not necessarily mean that a hospital
is performing poorly and that a short wait time does not mean
that a hospital is performing well. There are many factors,
including limits on human resources, demand for services,
and the complexity of the case/procedure that can affect the
wait time.
It is expected that the MOHLTC will have developed a comprehensive,
precise and timely Wait Time Information System by December
2006.
Our Breast Cancer Median Wait = 20 Days (better than
standard)
Wait Time Standard = 28 Days
Our GI Cancer Median Wait = 25 Days (better than
standard)
Wait Time Standard = 28 Days
Our GU (Prostate) Median Wait = 33 Days (better than
standard)
Wait Time Standard = 84 Days
Our Gyne Median Wait = 37 Days (not meeting standard)
Wait Time Standard = 28 Days
Our Head and Neck Median Wait = 24 Days (better than
standard)
Wait Time Standard = 28 Days
Our Thoracic Median Wait = 39 Days (not meeting the
standard)
Wait Time Standard = 28 Days
TBRHSC is performing well when it comes to cancer surgical
wait times. The Median wait is important here. The Median
wait time demonstrates the point at which half of the patients
have completed their surgery. The median is a way of reflecting
what a "typical" patient might have experienced
in that period of time. Unlike the average wait time, the
median will not be influenced by a few very unusual cases
(long or short), and therefore is more stable over time.
It should be noted that the information is populated through
the CCO website and then the MOHLTC posts the wait times (using
identical data). Locally we have found some small discrepancies
in the data posted. The MOHLTC will need to assess the quality
of the data on a go forward basis.
Cancer Care Ontario is working with hospitals to refine how
the wait time information is defined and gathered to continuously
improve the quality of information so that we will have a
more accurate picture of the time patients wait.
The average is the length of time the patients waited to
complete surgery. It is skewed in our region (for the most
part) due to small numbers (1-2) of outliers for breast and
gyne cancer.
The 90th percentile is the point at which 90 percent of the
patients have completed surgery and 10 percent are still waiting.
In each disease site, CCO has established and promoted provincial
"BEST PRACTICE" wait time standards for each of
the cancer surgery areas (the report has been submitted to
the MOHLTC by the Cancer Surgery Expert Panel awaiting approval
from the MOHLTC).
In July of this year, at a time when our surgical program
was compressed due to summer holidays, we met the best practice
standard for median wait times in almost every area.
It is important to remember that the data measures only the
length of time it takes for a patient to undergo a procedure.
Although this yardstick is important, that conclusions about
the quality of a hospital or about the quality of care received
at a hospital cannot be drawn from this snapshot.
A short wait time does not mean equal to a "good result"
and a longer wait times does not necessarily equal to a "bad
result"
For cancer surgery, we need good information to measure the
performance of cancer services and to identify key areas for
improvement.
Right now the MOHLTC website provides a snapshot of one point
in time - July, 2005. As the website is updated we will be
able to see the improvements made to system performance over
time.
The government has invested in increased cancer surgeries
across the province over the past year. We know that continued
investments in cancer surgery will impact on improving wait
times.
The goal is to provide more cancer surgery and improve the
quality of care across the province.
Tracking of how long cancer patients wait for surgery is
challenging because there are many patient-specific decisions
that can delay the time between diagnosis and surgery and
are factored in to wait times including:
- The availability of health professionals (anesthetists,
nurses, surgeons)
- The volume of procedures done at the hospital
- Previous wait lists
- Patient's health and readiness for surgery
- Requirement of other treatments such as chemotherapy before
cancer surgery
- Patient choice to delay surgery or cancel surgery
- Further diagnostic work up required prior to surgery
- Funding
Our hospital is working hard at serving our patients well.
Our surgeons prioritize cases based on the urgency of surgery
and more importantly they are active participants working
with us to improve the quality of care while reducing the
wait times for completion of surgery!
We will continue to ensure that our patients receive the
treatment they need while we continue to make system improvements!
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