High resolution analysis of wait times and factors affecting surgical expediency
DOI:
https://doi.org/10.5489/cuaj.553Abstract
Objectives: Wait times in Canada are increasingly being monitored
as an indicator of quality health care delivery. We created a higher
resolution picture of the wait experienced by urological surgery
patients beginning with the initial referral. In doing so, we hoped
to (a) identify potential bottlenecks and common delays at our
centre, and (b) identify predictors of wait time.
Methods: The charts of 322 patients undergoing surgery from
November 2007 to March 2008 were reviewed and specific dates,
patient factors and delays were recorded. The data were used to
detail the patient’s wait and to determine the patient factors which
were predictive of wait time.
Results: The mean time from decision to operate to the day of
operation was 75.87 days for all patients. This number accounts
for 53% of the wait time, while the time from referral to decision to
operate is 47%. Predictors of a decreased wait time include cancer
cases, younger age, urgency score, repeat patients and female gender
in multivariate analysis. Delays were experienced by 16.8% of
patients; most common delays were operating room cancellations/
time constraints, patients requiring further optimization and delays
in referral (4.7%, 3.4% and 3.1%, respectively).
Conclusions: The waiting process is complex; the actual waiting
time that a patient must endure is much longer than the wait times
traditionally recorded and reported by hospitals. As strategies are
implemented to decrease wait times, it will become increasingly
important to monitor the entire wait time from referral to operation
and to ensure that changes are being made that truly decrease
wait times and not simply shift where and when the patient waits.
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