B.C. surgical wait list in error by
nearly 14 percent
VANCOUVER – An audit of British Columbia’s elective surgical wait list
website found that 11,000 patients on a list of 80,000 shouldn’t be on
While that’s good news in terms of a reduced number of patients waiting
for surgery, it raises questions about how to accurately collect and
maintain data for such databases.
Dr. Penny Ballem, B.C.’s deputy health minister, said many patients have
already had their surgery, changed their minds about having it, or had
died while waiting. Of those who died, it is not known if their deaths
were related to the planned surgery or not.
The B.C. government is pledging to rectify the nearly 14 percent error
rate by unveiling an overhauled website by the end of the year.
A preliminary audit of the wait list website done late last year found
that 6,000 patients on the list of more than 80,000 were there by
mistake because hospitals, doctors and others who are submitting the
data failed to remove names when patients were no longer waiting.
As the audit has continued, the government discovered the website
actually overstated the number of those waiting by more than twice what
As a result of the six-month review of the ministry’s various data
sources, more than 10,000 patients have been identified who should no
longer be on the existing Surgical Waitlist Registry. This includes:
• 33 B.C. women waiting more than a year for their C-sections.
• 24 people waiting more than 18 months for a blood transfusion.
• More than 1,000 people on the list who are shown in the Vital
Statistics database to have passed away – some as long as five years ago
(the vast majority were listed for non-life threatening conditions such
as cataract surgery).
• More than 9,000 people on the wait list appear to have had their
scheduled surgeries months or years ago.
In British Columbia, more than half of all surgeries are identified and
done by physicians as emergency procedures. Under 50 percent are
waitlisted and results indicate that of these:
• 10 percent are done within a week.
• 25 percent are done in less than two weeks.
• 50 percent are done in just over a month.
• 75 percent are done in just over three months.
• 90 percent are done in less than seven months.
More work is necessary to identify patients waiting over seven months,
determine why their waits are inconsistent with the majority of patients
and consider strategies to expedite their care.
According to the B.C. Ministry of Health, there have been significant
improvements in access to surgery in priority areas identified by First
Ministers in fall 2004. For example, from 2000/2001 to 2003/2004:
• Knee replacements increased by more than 33 percent.
• Hip replacements increased by more than 21 percent.
• Cataract surgeries increased by 20 percent.
• Coronary bypasses increased by 21 percent.
• Angioplasties increased by over 40 percent.
In December 2004, there were 55 percent fewer patients waiting for
non-emergency cardiac surgery than in December 2002. The median wait
time for cardiac surgery in B.C. has fallen from 16 weeks to less than
nine, consistent with best practice. There is virtually no wait for
access to cancer surgery, the ministry said.
In addition to the ministry’s efforts, all health authorities along with
physicians from across B.C. are participating in a surgical services
project through the Provincial Health Services Authority.
The project will develop and implement clinical tools for doctors to
assess patients across several surgical specialty groups over the next
year. B.C. is building on the foundation work of the Western Canada Wait
List study as well as the Saskatchewan Surgical Care Network.
At the same time, B.C. is working to enhance and eventually replace the
existing waitlist registry by developing a system that supports the
physicians’ clinical assessment of their patients’ medical needs. This
future registry is being designed with links to the hospital information
system, to eliminate duplication and ensure that patients who have had
their surgery are cleared immediately from the wait list.