Benchmark standings for the last two quarters of 2009-2010: October 1 to December 31, and January 1 to March 31. The majority of patients are receiving timely access to radiation treatment, cardiac bypass surgery. However, given the fact that the continued increase in demand for joint replacement is concentrated in one region, wait times for hip and knee replacements are noticeably longer in Eastern Health. Cataract wait times vary across regions, and will continue to peak and trough in response to varying demand. The annual participation rates for breast and cervical screening are also included with this report.
Curative Radiotherapy
Radiation treatment wait time information for all disease sites including breast, lung, prostate and colorectal cancers for both quarters show that 86.8 to 93 per cent of a combined total of 409 new patients commenced treatment within 30 days, and that 205 of these new patients started treatment in under 14 days.
Cardiac Bypass Surgery
In both quarters combined, 184 cardiac bypass surgeries were performed. During the height of the pandemic in the Fall, a number of bypass cases were impacted by either postponement or delay because of the high demand on critical care beds to care for critically ill HINI patients.
The national benchmark for cardiac bypass surgery is multi-tiered with a 14 day access target for Level 1, 42 days for Level 2 and 182 days for Level 3. The corresponding wait time data for Level 1 cases shows that 100 per cent were carried out in 7 days, or half the target in the third quarter, and 100 per cent were completed in 14 days in the fourth quarter. At the 42 day mark, 80.8 to 95.8 per cent of Level 2 cases were completed, and 98.3 to 100 per cent of Level 3 cases were carried out within 182 days. As of March 31st, there were 55 patients on the cardiac surgery waitlist in this Province, and less than half of these are waiting for bypass surgery.
Cataracts
The national benchmark target for cataract procedures is 112 days. Eastern region carried out 67.7 to 72.5 per cent of cataract procedures on the first eye within this timeframe. In the Central region, the proportion of first eye cataract cases carried out within the target ranged from 58.6 to 90.9 per cent. In the third quarter, the proportion completed within 112 days in Gander decreased, as more long waiters were attended to this time. In the Western region, 75.5 to 78.1 per cent of first eye procedures were carried out within 112 days. While in Labrador-Grenfell region, 16.7 to 93.9 per cent of first eye cases were completed within the recommended timeframe, as the itinerant ophthalmologist did not visit the region during the summer months. Across the Province, more than 1,800 cataract cases were performed this time.
Hip Replacement
The national benchmark for hip replacement is 182 days. In Eastern region, 47.3 to 66 per cent of the 108 cases were carried out in this timeframe. The remainder of just over 70 cases were carried out in the other three regions. The proportion of cases completed in the 182 day target ranged from 94.7 to 95.7 per cent in the Central region, to 100 per cent in Western. Data are suppressed given the small number of cases done in Labrador-Grenfell region.
Knee Replacement
The national benchmark for knee replacement is 182 days. A combined total of nearly 325 knee replacement surgeries were performed this time. This represents three times as many knee replacements than hip replacements. The majority of cases or 190 were completed in the Eastern region, with 35.7 to 52.6 per cent done within 182 days. While the proportion of patients accessing knee replacement surgery in the fourth quarter period is the lowest percentage to date, the actual number of patients to undergo knee surgery increased from 78 in Q3 to 112 in Q4, an increase of 44 per cent. This increase may be attributed to the following factors: The Easter seasonal slowdown came a month later in April this year; there was a full complement of anaesthetists on staff; the orthopaedic surgeons prioritized cases and a high proportion of longer waiters underwent knee replacement in Q4.
In the Central region, 89.7 to 100 per cent of a combined 84 cases were performed in the same timeframe. Western Health performed 93.3 to 95.2 per cent of cases within the benchmark target. Labrador-Grenfell region data are suppressed in Q3, while in Q4, 100 per cent of cases were carried out within 97 days or nearly half of the benchmark 182 day target.
Hip Fracture Repair
The national benchmark for hip fracture surgery is 48 hours. In the Eastern region, 71.4 to 81.4 per cent of 140 cases combined were carried out within 48 hours. In the Central region, 100 per cent of 53 cases combined were done within 48 hours, and 85.7 to 95.5 per cent of more than 40 cases were done at the 48 hour mark in Western region. Data are suppressed for Labrador Grenfell region in this area due to small volumes in both quarters.
Breast Screening
The national benchmark for breast screening is that women aged 50 to 69 should be screened every two years. Biennial participation rates for the 2008-2009 calendar years at the three breast screening centres ranged from 54 per cent in Corner Brook, 59 per cent in St. John’s, and 80 per cent in Gander, while the provincial participation rate across these three centres combined is 60 per cent.
The total number of women screened increased by 11.6 per cent over the last reporting period, while the eligible population increased by 3 per cent at the same time. The overall result was an increase of 4 per cent of women aged 50 to 69 who participated in breast screening. According to the Public Health Agency of Canada, the national participation rate for organized breast screening was 43.3 per cent in 2006.
The catchment area of the Breast Screening Centre – St. John’s (Major’s Path) is the Avalon Peninsula. The catchment area for the Breast Screening Centre – Gander (James Paton Memorial Hospital) covers the area of Terra Nova to Glenwood, including all coast communities from Salvage to Port Albers. The area includes Change Island, Fogo Island, and Strong’s Island to Crow Head to Pike’s Arm. The catchment area for Breast Screening Centre – Corner Brook is the area covered by the Western Health Authority.
Cervical Screening
The national benchmark for cervical screening recommends that women begin screening at 18 years, and continue to be screened every three years to age 69 after two normal pap tests. This varies from the Provincial guideline which recommends that women should undergo an annual pap test. In keeping with the Provincial target, annual participation rates are reported for the 2009 calendar year. While the number of women screened increased by 1702 Pap tests from 2007 to 2009, the provincial rate was 43 per cent for the second consecutive year. Regional rates ranged from 37 per cent in Western region, to 39 per cent in Central, to 40 per cent in Labrador Grenfell region, to the highest participation rate of 47 per cent in Eastern region.
On a regional scale, Eastern and Labrador Grenfell regions each experienced a 2 per cent increase in the number of women screened between 2007 to 2009. This equates to 1556 additional Pap tests carried out in the Eastern region in 2009 compared to 2007, and 197 more in Labrador Grenfell region when comparing the same years. Central region achieved a 1 per cent increase, as 228 more Pap tests were done when comparing 2007 to 2009. In Western region, there were 279 fewer Pap tests carried out when comparing the same periods.
Provincial Wait Times Data
2009-10 Quarter 3: October 1 to December 31, 2009
| Service Area | Pan-Canadian benchmarks | Newfoundland and Labrador Wait Times – Third Quarter (October – December, 2009) |
|---|---|---|
| Curative Radiotherapy | Within 4 weeks (28 days) of being ready to treat. |
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| Coronary Bypass Surgery (CABG) |
Level 1 Within 2 weeks (14 days) |
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| Level 2 Within 6 weeks (42 days) |
|
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| Level 3 Within 26 weeks (182 days) |
|
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| Cataract | Within 16 weeks (112 days) for patients who are at high risk. |
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| Hip Replacement | Within 26 weeks (182 days) |
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| Knee Replacement | Within 26 weeks (182 days) |
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| Hip Fracture Repair | Fixation within 48 hours |
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| Breast Screening | Women aged 50-69 every two years | Biennial participation rates (percentages) for the 2008-2009 calendar years for each of the province’s 3 breast screening centres.
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| Cervical Screening | Women, starting at age 18, every three years to age 69 after two normal pap tests. |
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Source: Regional Health Authorities and the Provincial Breast Screening Program, Newfoundland and Labrador
Notes: Hip and knee replacement, as well as hip fracture repair data are suppressed for the Labrador Grenfell Health region, as a small volume of cases were performed during this quarter.
Provincial Wait Times Data
2009-10 Quarter 4: January 1 to March 31, 2010
| Service Area | Pan-Canadian benchmarks | Newfoundland and Labrador Wait Times – Fourth Quarter (January – March, 2010) |
|---|---|---|
| Curative Radiotherapy | Within 4 weeks (28 days) of being ready to treat. |
|
| Coronary Bypass Surgery (CABG) |
Level 1 Within 2 weeks (14 days) |
|
| Level 2 Within 6 weeks (42 days) |
|
|
| Level 3 Within 26 weeks (182 days) |
|
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| Cataract | Within 16 weeks (112 days) for patients who are at high risk. |
|
| Hip Replacement | Within 26 weeks (182 days) |
|
| Knee Replacement | Within 26 weeks (182 days) |
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| Hip Fracture Repair | Fixation within 48 hours |
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| Breast Screening | Women aged 50-69 every two years | Participation rates will be updated on an annual basis. |
| Cervical Screening | Women, starting at age 18, every three years to age 69 after two normal pap tests. | Annual participation rates (percentages) for the 2009 calendar year for each of the province’s 4 regions and provincially.
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Source: Regional Health Authorities and the Provincial Cervical Screening Initiative, Newfoundland and Labrador.
Notes: Hip replacement and hip fracture repair data are suppressed for the Labrador Grenfell Health region, as a small volume of cases were performed during this quarter.