Notes Regarding Surgical Wait Time Data
The intent is to provide the best information that is currently available. However, it is important to understand the source of the information and be aware of the strengths and limitations of the data as well as the decisions that were made in determining how best to present the data.
Source of Information
Most data is from Saskatchewan's Surgical Patient Registry. One exception is the wait times for hip fracture repair which comes from the Canadian Institute for Health Information’s database of hospitalizations known as the Discharge Abstract Database.
Privacy of health information is a priority for Saskatchewan. This website provides de-identified, summarized information to protect patient confidentiality.
Ten regional health authorities submit data to the Surgical Registry. These 10 health regions include all provincial, regional and district hospitals.
Inclusions and Exclusions
Data includes all operating room procedures, with the exception of most endoscopy procedures (colonoscopies, gastroscopies, sigmoidoscopies). Endoscopies performed under general anaesthetic in an operating room, and all endoscopies performed in operating rooms in Regina, Saskatoon and Prince Albert are included.
The several reports on this website allow you to view the results with emergency surgeries included or excluded. In other reports, emergency surgeries are excluded. Cases reported to the registry as emergency waitlist priority IV cases are counted as non-emergent. Definitions of emergency surgery are not currently standardized provincially. Emergency waitlist priority IV is used by some regions to identify the least urgent emergency cases.
The Saskatoon Health Region started adding patients from two paediatric dental clinics to the Surgical Patient Registry in 2006. These patients were entered onto the Surgical Registry as of their original booking date to retain their full waiting time. This means that the patient waiting counts for these cases go back further than 2006.
Starting in August 2010, regions were given the option to purchase surgeries from private clinics. Data for these surgeries are included here.
The website focuses on the time waited for surgery after the patient has seen the surgeon and decided to have the procedure performed (i.e. the booking date).
Wait times are calculated from the date that the health region receives the booking form from the surgeon until the date that the surgery is performed.
The wait times do not include the initial wait to see the surgeon. No data is currently available on waits to see a surgeon.
The wait times also do not include any delays that may occur between the date of the decision to have surgery and the date that the booking form from the surgeon is received by the health region. While such delays should normally be short, there are some cases where longer delays occur.
When wait times are reported in months, the following values are used: three months equals 91 days, six months equals 183 days, 12 months equals 365 days, and 18 months equals 548 days.
An adjustment is made to eliminate double counting of waits for patients who are booked at the same time for two cataract procedures. In practice, these patients will not be scheduled for the second eye until the first eye is done. The wait for the second eye is calculated from the date that the first eye procedure is done and the patient is counted as waiting for only one procedure at a time.
Patients who are waiting for surgery can specify time periods during which they will be unavailable for surgery (e.g. harvest time). Time periods during which a patient is unavailable for surgery are excluded from wait times shown on the website.
Scheduled surgery may be postponed for a variety of reasons. Sometimes there are system reasons, such as when a hospital bed is not available on the scheduled surgery date. At other times, the reasons are related to the patient. For example, a patient may request a postponement to a later date for personal reasons or a patient may not be well enough to have the surgery on the scheduled date. No adjustments are made for health system related postponements in the calculations of wait times.
A small number of cases that have errors in booking dates are excluded from the calculation of waiting times but are still included in the surgery performed volumes.
Due to rounding, the percentages shown may not total exactly to 100 percent.
The number of patients waiting is calculated as of the last day of the time period shown (a snapshot date).
The time already waited is calculated from the booking date to this snapshot date.
An operating room is a room equipped for performing surgical operations, and most procedures that patients would consider to be surgery are performed there. For example, major operative procedures like hip and knee replacements, coronary artery bypass graft surgery (heart bypass), hysterectomy, prostatectomy, cholecystectomy (removal of gall bladder) and resection of the bladder are always done in an operating room. So too are many other common procedures, such as tonsillectomies and cataract procedures.
However, there are also a variety of diagnostic and therapeutic procedures performed in other hospital settings, such as endoscopic rooms (e.g. colonoscopies), cardiac catheter rooms (e.g. angioplasties) and procedure rooms in ambulatory care (e.g. some types of biopsies) and emergency departments. Most of these procedures are not reported to the Surgical Patient Registry and all are excluded from this website’s data.
While major surgical procedures like hip replacements and heart bypass surgery are always performed in operating rooms, some minor procedures may be performed in operating rooms in some regions and not others. This occurs for a variety of reasons. Hospitals have different demands on their operating rooms, have different alternatives available, and make different choices about how best to provide services. Cystoscopy is an example of a procedure that is often performed in other locations, but is sometimes performed in an operating room and reported to the registry.
Sometimes a procedure is performed in an operating room only under certain circumstances. For example, a tooth would normally be extracted in a dental clinic, but may be done in an operating room when a general anaesthetic is required (e.g. for very young children or children and adults with special needs).
Some reports on this website allow you to view surgical volumes and wait times by surgeon specialty.
Some common procedures may be performed by more than one specialty in a region, or by different specialties in different regions. For example, common back and neck surgeries (laminectomy/discectomy/fusion/decompression) are performed by both neurosurgeons and orthopaedic surgeons; tonsillectomies are performed by both otolaryngologists and general surgeons; and carpal tunnel procedures are performed by general surgeons, orthopaedic surgeons and neurosurgeons. Thoracic procedures (operations of the chest) are reported as cardiovascular procedures in Regina and as general surgery procedures in Saskatoon.
General practitioners may have hospital privileges to perform some general surgery and/or obstetrics and gynaecology procedures.
The “Other” category for surgeon specialty includes general practitioners as well as other specialties that occasionally are listed as the main provider for an operating room procedure (anesthesia, pediatrics, physical medicine, rehabilitation, psychiatry, and rheumatology).
A Note about Registry Data
The data provided on this website is from Saskatchewan’s Surgical Patient Registry. The registry is a live database updated continually for use in monitoring and managing wait lists. The data shown on the website represents a snapshot of the data in the registry at a point in time. Historical numbers are recalculated based on the current snapshot when the website is updated and will reflect any changes to the data that occur between snapshots. Data can change between snapshots for a variety of reasons.
Program changes in regions. For example, the addition to the registry of patients from two pediatric dental clinics in Saskatoon that were previously tracked separately and not in the registry affects counts of patients waiting. Both current and past wait list counts are affected because these patients are added as of their original booking date to retain their full waiting time.
Changes recommended by the SSCN to improve accuracy and facilitate interpretation of data. For example, a change was made in April 2006 to eliminate double counting of cataract patients who are booked at the same time for two cataract procedures.
Data entry and/or corrections that occur after the snapshot date. The data snapshots used for the website updates are taken approximately four weeks after the end of the time period covered (e.g. the snapshot of January to June data would be taken at the end of July) to ensure that data entry is complete, but occasionally late entry of a record occurs. Changes may also be made to fill in missing information, fix an error that is discovered, or to update a record with new information (for example, if a patient switches to a surgeon in a different region or new patient unavailable days are recorded).
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