Innovative surgical projects show how waitlists can be solved: Submission to BC 'conversation on health'

May 8, 2007

Surgical waitlists can be dramatically cut if the BC government takes
leadership by scaling up innovative projects already underway in the
public system, a new study says.

Why Wait? Public Solutions to Cure Surgical Waitlists,
released today by the CCPA and the BC Health Coalition, is a submission
to the BC government's 'conversation on health.' The study looks at
five groundbreaking projects in BC, and successful initiatives in
Alberta, Saskatchewan and Ontario. The projects reveal two key changes
that will cut wait times if the BC government implements them at a
province-wide level:

  • Team-based care: Surgeons moved
    from working mainly on their own to working in teams in specialized
    clinics. Patients are better prepared for surgeries, operations are
    less likely to be cancelled, operating rooms function more efficiently
    and hospital stays are shorter. These projects also make greater use of
    nurses and other health care workers at every stage of the process.
  • Pro-active
    waitlist management: Shifting responsibility for managing waitlists
    from individual surgeons to health authorities means patients can
    access the first available surgeon. (People who want to choose their
    surgeon still can.) Health authorities in turn can make sure
    efficiencies and best practices from individual hospitals are applied
    across the system. Such strategies are used successfully by provincial
    governments in Saskatchewan and Ontario.

The Joint Replacement Access Project at Lions Gate Hospital reduced
median wait times for first surgical consult from almost a year to just
four weeks, and reduced wait times for surgery from as long as two
years to six months.

"Without any additional resources we
created an innovative model to realign and improve patient care and
access," says Dawn Stangl, Manager of Surgical Access for the Coastal
Health Service Delivery Area. "This new model of care was
collaboratively developed with the key support of physicians,
healthcare providers and administrative leaders." Chantel Canessa, an
Orthopedic Nurse Clinician with the project, emphasizes the importance
of listening to patients. "Feedback received from patient focus groups
was used as a roadmap for system redesign. We've already taken the
lessons learned at the joint clinic and are applying them in our Rapid
Access Spine Clinic."

Cindy Roberts, who co-led Richmond
Hospital's Hip and Knee Reconstruction Project, says, "The strides we
have made are quite remarkable, given the increased demand for hip and
knee joint replacement service. We reduced median wait times for
completed hip and knee joint surgery from nineteen months to under six
months. Another significant outcome of the project is the practical
'tool kit' we have shared with other hospitals in BC, enabling them to
learn from the work undertaken at Richmond."

The Saskatchewan
Surgical Care Network, Canada's first province-wide surgical patient
registry, has used pro-active strategies to reduce wait times.
"Accurate data is essential for creating management strategies and
targeting resources for achieving long term success in wait list
management," says network Chair, Dr. Rob Weiler. The network doesn't
just report waitlists -- regional health authorities are expected to
actively manage them in partnership with surgeons.

"The BC
government launched its 'conversation on health' by saying it has no
choice but to consider private options," says report co-author Alicia
Priest. "But these initiatives prove there are low-cost, public
solutions to long waits for surgery. We should be shouting from the
rooftops about them. Their success is outstanding, as is the excitement
and dedication of their clinical and administrative leaders."

are innovative public solutions available to us right now," says
co-author Marcy Cohen. "Scaling them up to a province-wide level will
require a lot of collaboration and some major cultural shifts in how
our surgical system functions. Allowing more private clinics will make
those changes difficult -- if not impossible."

"We don't hear a
lot of good news about the health care system," says co-author Dr.
Michael Rachlis. "But there are plenty of reasons to be optimistic.
There's this myth out there that only the private sector can innovate,
but this study shows that is false."


Why Wait? Public Solutions to Cure Surgical Waitlists
was released today by the Canadian Centre for Policy Alternatives' BC
Office and the BC Health Coalition. The study can be downloaded from

To arrange an interview, call Terra Poirier, 604-801-5121 x229 or Shannon Daub, 604-801-5121 x226 (cell 604-836-9372).

For BC Health Coalition interviews only, call Leslie Dickout at 604-681-7945.