Initiatives in Saskatchewan

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Managing Surgical Care Access

• Initiatives in Saskatchewan

Jeff Brown Surgical Registry Office
Manager Saskatchewan Health
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Presentation - Key Topics

• Overview of the SSCN
• Members and structure
• Status of surgical care system initiatives
• Surgical Patient Registry
• Patient Assessment Process
• Target Time Frames for Surgery
• Progress made

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Access to Care

• Provinces and territories have all faced the
  issue of waiting times and we have all increased
  funding in this area.
• We have also recognized that funding alone is not
  the solution.

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Surgical Care Issues Recent History

• In 2001, Health Minister John Nilson appointed a
  Provincial Wait List Strategy Team to look
  specifically at surgical waiting list issues.
• Chaired by Dr. Peter Glynn, and included Dr. Mark
  Taylor and Dr. Alan Hudson.
• The task was to review current initiatives in
  Saskatchewan, across the country and around the
  world.
• Recommend a strategy to help Saskatchewan improve
  access to needed surgical procedures.

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Surgical Access Issues - Saskatchewan

• The team identified several issues
• Lack of consistent, accurate data on surgical
  wait lists
• No consistent patient prioritization processes
• Large differences in waiting time between
  surgeons for elective patients
• Only intermittent coordination and cooperation
  between Health Regions on surgical services
  issues.
• Referring physicians do not have sufficient
  information to inform patients of waiting time
• Surgeons frustrated with inability to operate on
  elective patients in a timely manner and,
• Public frustrated with lack of timely access to
  elective surgical procedures.

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Wait List Management Strategy

• Saskatchewan outlined its surgical care strategy
  within the Action Plan for Saskatchewan Health
  Care (2002). It lists several priority
  initiatives, including the establishment of
• The Saskatchewan Surgical Care Network (SSCN)
• A Surgical Patient Registry
• A Clinical Prioritization Process Target Time
  Frames for Surgery
• A Waiting List Web Site and
• Surgical Care Coordinators and Regional Contacts

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Pulling the Strategy Together

• To oversee development and implementation of the
  initiatives, the Saskatchewan Surgical Care
  Network (SSCN) was established as an advisory
  body to Saskatchewan Health in March 2002.
• Peter Glynn, was appointed as Chair of the
  Network, along with 15 members representing
  surgeons, Health Regions, regulatory bodies and
  Saskatchewan Health.
• SSCNs vision is
• Timely and appropriate surgical care for all
  Saskatchewan residents.

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SSCN Membership
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Key InitiativesSurgical Patient Registry
Surgeons - are responsible for assessing
patients, making the final determination as to
which patients will be the next to receive their
procedure and performing surgery. Regions - are
also responsible for patients and managing
surgical access. This includes effective
scheduling of patients, OR allocation, patient
flow and management of financial and human
resources.

• Surgical Patient Registry
• Tracking patients booked for surgery in ten
  health regions.
• It produces accurate reports that include
• Patients waiting
• For how long
• For what procedure
• For which surgeon and
• At what level of priority.

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A Key Issue We know that while many patients
receive their surgery quickly, others wait too
long.
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A Key Issue We know that while many patients
receive their surgery quickly, others wait too
long.
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SSCN Initiatives Patient Assessment Process
New Patient Assessment Process (Fairness and
Consistency)
Patient Assessment Process includes 1) Patient
Assessment Tools 2) Urgency Profiles for Surgical
Procedures 3) Priority Classification Levels
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Urgency Profiles for Surgical Procedures

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Priority Classification

• Priority Classification Table

Redefine Terms Emergent, Urgent and
Elective
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Patient Assessment Process-- Example of
Cholecystecomy (Gall Bladder removal)
Assume General Surgery Tool Assessment Score
60
Patient is classified as Priority Level III.
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Key Initiative Target Time Frames for Surgery
In March 2004, we announced the following
performance goals for the surgical care system.
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Saskatchewan Surgical Strategy Summary

• Saskatchewans work has been focusing on
  development of the priority surgical access
  initiatives.
• Current and future focus will be on
• Implementing management initiatives to assist the
  regions in using registry data modeling software
  to help achieve targets.
• Medical diagnostic services and, in particular,
  the need to address current access issues related
  to certain diagnostic tests.

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Thank You