Released on March 17, 1999
Health Minister Pat Atkinson today said that the government will movequickly to shorten waiting times for surgery, based on the
recommendations of the Report of the Task Team on Waiting Lists for
Surgery. The report was released today by Dr. Stewart McMillan and
team members Dr. Barry Maber and Dr. Mark Ogrady.
The task team was appointed in December 1998 to recommend development
of a system that ensures appropriate and timely access to surgery and
to determine the necessary resource allocations. The study found that
prescribed time frames have generally been met for those patients with
emergency or urgent conditions but that improvements are required for
elective surgeries.
The committee made 23 recommendations in the 21-page report, including
to:
Provide funding for additional surgical equipment and more
operating room hours;
Change systems so that physicians can assign priority to elective
surgery patients according to medical conditions;
Co-ordinate 24-hour post-operative care in districts surrounding
Regina and Saskatoon;
Serve more patients through day surgery and do more procedures
through alternate ambulatory care settings instead of in
operating rooms;
Inform patients about their options and how surgical waiting
lists operate; and
Establish a committee to oversee improvements, review problem
areas and monitor the system.
"I will be moving on these recommendations without delay,"
Atkinson said. "This report is an action plan that will result
in a reduction in waiting times for elective surgery.
"As was indicated in the throne speech, measures to reduce
waiting times are a top government priority. Next week's budget
will demonstrate this commitment. I will also be working with
health districts, physicians, the College of Medicine and other
health care providers to ensure that the report's proposals for
increased co-ordination are implemented."
McMillan said that changes were required to ensure a fair and
responsive system for accessing surgery. "I believe that these
recommendations will make the system more transparent, more
accountable and more effective in responding to the needs of
patients."
Atkinson thanked the task team members. "In a very short time,
these doctors have tackled a very complex issue and have provided
us with a blueprint for change which I will begin to implement."
Copies of the report are available from Saskatchewan Health.
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For more information, contact:
Jeff Brown
Communications Branch
Saskatchewan Health
Regina
Phone: (306)787-4088
Report of the Task Team on Surgical Waiting Lists
Summary of Recommendations
This report outlines the findings of this Task Team. In making recommendations we have appended our sense of
whether they can be achieved in the short term (3 to 6 months) medium term (6 to 15 months) or long term (15 to 24
months).
Recommendations
1 That the departments of surgery in Regina and Saskatoon in co-operation with the Department of Health develop consistent definitions of surgical needs and that the system be tracked to ensure consistent application of these definitions (short term).
2 That the surgeon responsible for the patient have the ability to prioritize patients within his/her waiting list and that where chronological systems are currently in place they be modified to permit other than chronological prioritization (short term).
3 When the allocation of surgical times in Saskatoon and Regina is undertaken, that provision be made for the allocation of urgent time to be assigned during regular operating time based on a regular analysis of operating room utilization (short term).
4 That the Regina and Saskatoon district health boards have an operating room information system that ensures sufficient information is available to support a surgical times allocation system as envisaged above. This system, staffed with appropriately trained personnel, should support the collection, analysis and reporting of information that will be required to monitor access to surgery on an ongoing basis (short term)(see also recommendations on a provincial surgery advisory committee).
5 The Saskatoon district health board's, Surgical Operations Committee be given the responsibility of maintaining a centralized surgical waiting list for the district for all acute care facilities in the city. They will be responsible for the allocation of operating time throughout the system (short term).
6 The Task Team strongly recommends that any additional funds for surgical services in Saskatoon not be allocated or expended until the above recommendation is implemented (short term).
7 The Task Team recognizes that the academic faculty practising at the Royal University Hospital has considerable responsibilities to teaching as well as patient care and that it is important to ensure that surgical allocations adequately support the various training programs. We would encourage that any allocations consider the input of the Academic Head, Department of Surgery and the College of Medicine but that such considerations not overshadow the need to ensure appropriate access for patients and appropriate management of the district's resources (short term).
8 That the Regina and Saskatoon district health boards urgently explore the capability to move certain surgical procedures out of the operating room to an ambulatory care setting and to ensure that day surgery facilities are maximally utlized (short term).
9 That the districts regularly and consistently report the number of procedures performed as in-patient that would not normally require hospitalization (medium term).
10 That the Regina district health board review the current surgical service mix between the two acute care facilities to ensure that efficiencies gained with increased ambulatory care surgery can be fully optimized (short term).
11 That the Saskatoon and Regina district health boards plan to implement a working schedule that does not include one week of shortened operation (i.e. the 5-5-4 rotation) as soon as staffing complements permit.
12 That the Department of Health provides capital funding for equipment necessary to implement greater efficiencies in the operating room and ambulatory care (short term).
13 That in the future the Department of Health reviews with the districts the mechanism used to allocate funds for capital equipment and to show this in a transparent fashion in district allocations (medium term).
14 That the Department of Health mandate as a provincial standard that all health districts have available a 24 hour resource that ensures patients can be returned to the most appropriate service in their home district when medically appropriate and without delay (short term).
15 That districts outside Regina and Saskatoon that have qualified surgical personnel and available capacity develop a strategy to inform referring physicians of the services available (short to medium term).
16 That a peer review network be established to ensure that any surgical workload increases outside Regina and Saskatoon are done in an environment that ensures appropriate peer review and that the type of service does not exceed the capacity of a facility to support it (medium term).
17 That the Saskatoon district health task force on access to elective surgery study the implications of the Task Teams report with respect to the required number of day time operating rooms a the Royal University Hospital site and provide a report with supporting rationale to the provincial task team on the capacity required (short-term)
18 That research into the appropriateness for surgery be closely followed critically appraised and incorporated into the surgical management systems in Saskatchewan (short, medium and long term).
19 The Department of Health in conjunction with the district health boards and relevant professional regulatory organizations develop a comprehensive human resource policy to address the need for recruitment, retention, training and retraining of health personnel.
20 That a mechanism be developed to study the scope of practice of health disciplines to determine if an alternative deployment of human resources would benefit the system.
21 That the districts of Regina and Saskatoon develop a central resource that allows patients and physicians to be advised on wait times and projected waits for surgery (short to medium).
22 That the Department of Health in conjunction with the districts develop a patient information brochure that explains the surgical booking system, the categories of surgery prioritization and advises them of the steps that they may take should they feel that their condition has deteriorated since the time of booking (short to medium).
23 That a permanent advisory committee with representation from the Department of Health, the Saskatoon and Regina health districts and the public be formed to monitor access to surgery in the province and
monitor the implementation of the recommendations contained within this report. The advisory committee should receive and review regular performance reports relating to access to surgery in the province. The
committee should be chaired by the Assistant Deputy Minister responsible for Acute and Emergency Services Branch, Saskatchewan Health, and a report should be issued annually to the Deputy Minister of Health. Included in the appendix is a description of the functions that we would expect the advisory committee to discharge.