Improving Pediatric Surgical Wait Times With Pan-Canadian Benchmarking Data

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A special project implemented by CIHI is providing unique and essential benchmarking information used to improve surgical wait times in pediatric health centres across Canada.

This project, known as Special Project 050, is an innovative, low-cost solution that enables the continued collection of data from the Canadian Paediatric Surgical Wait Times Project (CPSWTP).

The CPSWTP developed and implemented a system for measuring, monitoring and managing pediatric wait times for surgery for waiting and completed cases using the Paediatric Canadian Access Targets for Surgery (P-CATS). 

Benchmarking data for better planning and decision-making

At its peak, 24 hospitals across Canada, including 16 pediatric academic health sciences centres, participated in the CPSWTP. With the knowledge that CPSWTP funding would cease in 2013, CIHI, the Canadian Association of Paediatric Health Centres (CAPHC)—Canadian Paediatric Decision Support Network (CPDSN) and the leadership of the CPSWTP collaborated to provide participating pediatric centres with continued benchmarking data on completed cases for better planning and decision-making. The Paediatric Surgical Chiefs of Canada (PSCC) were integral partners in this collaboration, demonstrating clinician engagement, commitment and support vital to project success.

Continued benchmarking data is made possible through the use of Special Project Fields in CIHI’s Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS), along with Portal, one of CIHI’s analytical web-based tools. The CAPHC-CPDSN Community of Practice on Portal provides quarterly and annual reports to the pediatric community, including the PSCC.

Leveraging solutions to common issues

The data addresses the full spectrum of conditions in children and youth, using the diagnosis-based P-CATS codes—867 diagnoses in 11 surgical disciplines—with attached access targets developed by consensus of more than 100 pediatric surgeons across Canada. This is the only source of comparable pediatric surgical wait time information in Canada.

“By using common standards (P-CATS), participating hospitals can easily leverage solutions to common issues. This increases efficiency and, in the end, reduces the percentage of children exceeding acceptable wait times,” explains Dr. James G. Wright, leader of the CPSWTP and chair of the PSCC. “Due to CIHI’s hard work with Special Project 050, we have expanded by allowing any institution across any jurisdiction to participate in pediatric surgical wait times benchmarking using Paediatric Canadian Access Targets for Surgery (P-CATS) codes. And with the help of Portal services, past recommended surgical access targets from completed cases were provided to CAPHC-CPDSN members.”

CIHI’s partnership with CAPHC

CIHI continues to work closely with CAPHC’s CPDSN, its data-sharing and national benchmarking program, to ensure that better pan-Canadian data is available to participating centres. An example of such efforts is CIHI’s breakfast symposium at the 2014 CAPHC Annual Conference in Calgary, where the better utilization of Special Project 050 for localized and specialized needs was discussed. Currently, CIHI is in its second year of collecting information from 9 centres; it is hoped that that number will increase in the near future.

“Special Project 050 has enabled consistency in data access, definitions and interpretation and has established an unprecedented opportunity for data-sharing and national benchmarking,” says Elaine Orrbine, President and CEO, CAPHC. “CAPHC’s partnership with CIHI has resulted in enhanced capability for accessing key pediatric benchmarking data in support of our collective goals and objectives in improving decision-support opportunities.” Any facility that submits to the DAD and NACRS can submit pediatric surgical wait time data.

Building standards, decreasing surgical wait times

“CIHI’s relationship with CAPHC goes back to 2005,” says Brent Diverty, CIHI’s vice president of Programs, explaining how important it is for CIHI to maintain a strong relationship with its partners and stakeholders. “Last year’s breakfast session at the CAPHC Annual Conference gave us the chance to demonstrate the potential behind Special Project 050. Through the comparative data gathered in this initiative, we are helping participating organizations explore ways to decrease surgical wait times in pediatric centres. We believe that our DAD and NACRS databases, with the help of our Portal reporting and analytical services, will continue to help make benchmarking opportunities for our clients possible.”

Increasing the number of participating centres and stakeholders is important for valuable benchmark reporting. Enhancing data collected through Special Project 050, such as through participation in the current P-CATS Update project, demonstrates CIHI’s commitment to enhancing the utility of pediatric surgical wait time information. The expansion of the DAD and NACRS Special Project capabilities to collect other information and data of interest to the pediatric care community is a key initiative.

“I would like to sincerely thank CIHI and their dedicated staff for embracing P-CATS in CIHI’s system and building Special Project 050 to enable continued benchmarking of pediatric surgical wait times across Canada,” says Dr. Wright. “We look forward to our continued collaboration on this very important work.”