Braid: UCP says new reporting standard shows big improvement in surgery wait times

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Last Oct. 27, Premier Danielle Smith said the crisis in health care was over.

The other promise — made last Feb. 27 — was to perform all surgeries within clinically accepted wait targets.

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The crisis claim wasn’t specific. Many people in the system didn’t think the crisis ended then, and don’t believe it now.

The surgery-wait promise, by contrast, was very clear. By the end of this month all surgery waits would be performed “in target.”

That promise always seemed at best extravagant, at worst a pre-election pitch with scant hope of achievement.

But the latest government figures, from November, show that 40.2 per cent of all surgical waits were still “out of target.”

In October, 56 per cent of hip surgeries were delayed too long.

In all the intense blowback aimed my way, from both Alberta Health and even the premier’s office, nobody claimed those numbers can be reduced to zero by the end of this month.

The critics focused their ire on one claim in the column, and I have to concede they were right.

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Taking data from a government website, I said the wait time for a new knee was 99.6 weeks. By late last year, it had grown to 101.6 weeks.

I assumed those figures represented averages. In fact, they’re a snapshot of the 10 per cent longest waits. So, that was misleading.

But those are still very long waits for the 10 per cent of folks needing knee replacements.

In fact, some experts advocate focussing on the longest waits, because average numbers hide system failures and make the data look better.

Officials now say the site I referred to — Alberta Wait Times Reporting — is obsolete and doesn’t use up-to-date parameters.

Well then, why is it still pumping out readings based on the latest data?

There’s no good answer for that question. But officials insist the accurate site is the Alberta Surgical Initiative Dashboard.

Using calculations from that source, Health Minister Adriane LaGrange jumped in with a tweet criticizing my “incorrect use of data.”

She said provincewide surgical wait times have dropped dramatically. For hips, the wait has fallen from 33.3 weeks in October 2022, to 21.7 weeks a year later.

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Knee surgery delays were cut from 44.4 weeks to 26.3 weeks over the same period, LaGrange said.

Adriana LaGrange
Alberta Minister of Health Adriana LaGrange makes a health-care announcement in Calgary on Thursday, Dec. 21, 2023. Todd Korol/The Canadian Press

Obviously, there’s a huge gap between the conclusions on the “obsolete” site and the newer one, even though they both start with the same information.

And here’s the reason, according to officials.

The old site calculated wait times from the date of a surgeon’s “decision to treat.”

The new one starts the clock when the surgeon is “ready to treat.”

Sounds like a minor adjustment, but it has a huge effect on reported wait times.

The government says the old standard includes people who need a joint replacement but aren’t yet fit for surgery, usually for other medical reasons.

That creates many long delays that aren’t related to surgical capacity.

“Ready to treat,” on the other hand, kicks in when the surgeon says a patient is fully fit for the OR, and moves to book a time.

This sharply shortens estimated wait times. It’s why LaGrange can report conditions that look so much better.

Peter Lougheed Centre
The Peter Lougheed hospital in Calgary on Monday, January 8, 2024. Darren Makowichuk/Postmedia

At this point, some readers waiting for surgery are probably slapping their foreheads.

They know their own waits are far longer than anything shown in the minister’s figures.

The calculations don’t include the time between a GP saying you need a new hip or knee and that doctor getting you an appointment with a surgeon.

This can take many weeks or months. Then the specialist might want tests or diagnostics.

More time passes before the surgeon declares you “ready to treat.” And there’s further delay until the operation.

By this time, a patient in severe pain has often waited longer than a year.

Essentially, the government now bases its reports on the last mile of a long road.

Don Braid’s column appears regularly in the Herald

X: @DonBraid

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