Data Sources

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

Data is from the Saskatchewan Surgical Care Network’s Surgical Patient Registry.

Privacy of health information is a priority for the SSCN. This web site provides de-identified, summarized information to protect patient confidentiality.

Ten Regional Health Authorities submit data to the Registry. These ten Health Authorities include all provincial, regional and district hospitals.

Wait Times

The web site focuses on the time waited for surgery after the patient has seen the surgeon and decided to have the procedure performed.

Wait times are calculated from the date that the Regional Health Authority 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 Regional Health Authority. While such delays should normally be short, there are some cases where longer delays occur.

The wait time groups are calculated as follows:

A change was made in April 2006 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. Prior to April 2006 two patients waiting were counted from the initial booking date and the waiting times for both eyes were calculated from the initial booking date. Now, 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. All data on the web site has been adjusted to reflect this policy change.

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 web site.

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. All postponed surgeries are included in the counts of patients waiting and no adjustments are made for postponements in calculations of wait times currently shown on the web site.

Cases shown include all cases performed during the time period. A small number of cases (0.01%) that have errors in booking dates are excluded from the calculation of waiting times.

Due to rounding, the percentages shown may not total exactly 100%.

Patients Waiting

The counts of patients waiting for surgery include all patients waiting for an operating room procedure. No exclusions are made. In the past, different regions have used different counts to monitor trends. For example, Saskatoon used to exclude patients that were already scheduled for surgery from its patient waiting counts.

The number of patients waiting is calculated as of the last day of the time period shown.

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 counts of patients waiting for surgery in the Region were increased retroactively. Patients who previously would have been treated in the two paediatric dental clinics have been treated in an operating room at the Royal University Hospital since September 2006.

Procedures / Surgery Performed

The procedures that are included on the web site represent surgery performed in hospital operating rooms, including both scheduled and emergency surgeries.

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. These procedures are not reported to the Surgical Patient Registry and are not included in web site 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).

The web site shows wait time data for the most common surgical procedures or groups of procedures for which patients wait. They are grouped under the specialty of the surgeon that performs them.

Procedures are shown in a region only if there were 20 or more cases performed during the six-month time period or if there were more than 20 patients waiting for the procedure at the end of the time period. Wait time distributions are shown only if there were 20 or more procedures performed in the Region.

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. If the volumes are high enough, the same procedure may be shown in more than one specialty.

General practitioners may have hospital privileges to perform some General Surgery and/or Obstetrics and Gynaecology procedures.

In some cases more than one procedure may be performed in the same operating room session. Only the most important procedure is reported.

Cancer Services

Information specific to the cancer surgery case data is contained in the Cancer Services "Description of Data" and "Target Time Frames (cancer)" pages and in the notes that are included with each of the tables.

System Trends and Performance

Seasonal fluctuations in volumes of surgery are normal.

Median wait times are shown by the specialty of the surgeon. Procedures performed by General Practitioner Surgeons are included in a specialty (ie. General Surgery or Obstetrics and Gynaecology) if the Region has indicated that they have privileges in these areas.

Cases reported to the Registry as emergency level IV cases are counted as non-emergent cases in the median table. Definitions of emergency surgery are not currently standardized provincially. Emergency priority level IV is used by some regions to identify the least urgent emergency cases.

Performance measures for pan Canadian benchmarks and Saskatchewan target time frames are described in notes to the tables and graphs.

A Note About Registry Data

The data provided on the SSCN web site 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 web site 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 web site is updated and will reflect any changes to the data that occur between snapshots. Data can change between snapshots for a variety of reasons.