National Paediatric Surgical Wait Times (NPSWT) Project - Stage I

The NPSWT Project - Stage I was announced in January 2007 by Prime Minister Stephen Harper to measure surgical wait times for children and youth in six targeted areas:

• Cancer Surgery
• Cardiac Surgery
• Dental Treatment Requiring Anesthesia
• Neurosurgery
• Scoliosis Surgery
• Strabismus Surgery.

The overall goals of the NPSWT Project - Stage I included the development of a pan-Canadian paediatric surgical wait time database and a Clinical Pathway Guideline for children who wait beyond the access targets in Cancer Surgery.

The Project began in March 2007 and completed in June 2008. Following is a summary of the NSPWT Project - Stage I achievements.

• All PAHSCs collected wait time data using national standardized access targets, and submitted it to a national database. For the first time PAHSCs were able to benchmark themselves with peers through standardized data, as well as allocate resources and manage wait lists based on acuity.

• All PAHSCs adopted and used the Clinical Pathway Guideline, developed to expedite Cancer Surgery cases not meeting access targets.

• The surgical access targets adopted by the Pilot Project (previously developed by the Ontario Child Health Network) were updated by convening expert panels of over 100 surgeons in 11 surgical specialties from across Canada. The access targets are now called the Paediatric Canadian Access Targets for Surgery (P-CATS).

The following recommendations ensued from the NPSWT Project - Stage I:

1. Develop a means to sustain pan-Canadian data collection and analysis
2. Identify strategies to reduce amount of time children wait for surgery
3. Expand use of access targets to all surgical subspecialties
4. Expand implementation of access targets to community hospitals
5. Increase comparability of wait time data
6. Conduct a national performance improvement analysis
7. Conduct a national capacity analysis
8. Include Wait 1
9. Use lessons learned to address adult wait times
10. Create effective stakeholder engagement and collaboration strategy.

In June 2008, Health Canada announced further funding to implement some of these recommendations. The Project, now renamed the Canadian Paediatric Surgical Wait Times (CPSWT) Project – Stage II is funded until March 2010.

Canadian Paediatric Surgical Wait Times (CPSWT) Project - Stage II

Overview (until Mar 2010)

The accomplishments and recommendations of the NPSWT Project - Stage I, and the high levels of collaboration and support from the participating hospitals in moving forward prompted a proposal for continuing and expanding the scope of the Project.

1. Steady State

To sustain the achievements of Stage I, it was proposed that the CPSWT Project - Stage II should at minimum:      

1. Continue with wait time data collection and reporting at the sixteen PAHSCs across Canada.
2. Continue tracking the use of Clinical Pathway Guideline for cancer cases at the sixteen PAHSCs across Canada.
   

2. Enhancements

In order to improve the accuracy of the data collected, Stage II of the Project will implement key enhancements, as follows:

1. Move towards resolving minor variations in data definitions
2. Collect wait time data in all surgical subspecialties
3. Implement revised access targets (P-CATS)
4. Implement the Clinical Pathway Guideline in one additional area

3. New Initiatives

The new initiatives are aimed at increasing the impact of the Project on long-term wait list management.

1. Expand network to Community Hospitals - to measure wait times for additional children and youth in Canada, as well as gain a better understanding of waits for children in different contexts.
2. Develop Surgical Indications for one surgical procedure – to ensure that only patients who are appropriate candidates for surgery be contained on surgical wait lists. 
3. Conduct a Capacity Analysis study – to better understand the relationship between capacity and demand for surgery. 
4. Gather and share best practices in OR Performance Improvement – to enable participating hospitals to understand, measure, and compare their efficiency and productivity with their peers across the country.
5. Sustainability planning – to continue monitoring wait times using the national standardized Paediatric Canadian Access Targets for Surgery (P-CATS).

Learn more about the Stage II - Funding announcement (July 2008)
Learn more about the Stage I Funding announcement (January 2007)
Learn more about the “Children Wait Too": Final Report (April, 2006)
Learn more about the CCYHC National Paediatric Surgical Wait Times Strategy