Delivery of Urgent Cancer Surgery in Saskatchewan within Standardized Timeframes

Summary

For over 10 years, the province of Saskatchewan has been measuring and reporting on cancer surgery wait times. In fact, the province has been a leader in this area within Canada. In March 2013, the Saskatchewan Ministry of Health and the Canadian Foundation for Healthcare Improvement commissioned a report to support policy decisions concerning the setting standards, collecting data and reporting on the delivery of urgent surgical cancer care in Saskatchewan. This work supports the Saskatchewan Surgical Initiative and one of the provincial improvement targets related to the delivery of cancer surgery and treatment within consensus timeframes. As an impetus to this work was the fact that the province’s historic classification system and target timeframes for urgent cancer surgery were not perceived to be fully supported and would be impacted by the new three-month elective surgery wait time standard. This report and its recommendations will inform any potential changes.

Recommendations

  1. Wait Time Intervals: Add new band at 6 weeks in addition to existing bands (3 bands) 3 weeks, 6 weeks, 3 months 
  2. Develop a Surgical Oncology Quality Program 
  3. Eliminate or revise the Priority Assessment Tool 
  4. Identify process improvement opportunities with operating room booking 
  5. Develop consistent provincial policy and process guidance for wait list management
  6. Identify new innovation and leadership opportunities such as Wait 1 measurement and work towards measurement of total “cancer treatment wait time” trajectory, including the period from symptom presentation to first consultation to first treatment

This report recommends that Saskatchewan move beyond the addition or changes to wait time intervals or targets. A more effective measure to ensure transparent, consistent and high quality care lies in a holistic approach to creating a quality program in surgical oncology. This Program must be supported by dedicated leadership and allow for collaboration across the Government, clinicians, administrators and patients. Through the Program, these parties can work together to define and design processes, tools to guide practice and mechanisms to collect and report data to measure and manage multiple aspects of quality care.