National Benchmarks

What are Benchmarks?
Benchmarks are evidence-based goals that express the amount of time that scientific evidence shows is appropriate to wait for a particular service. They are not care guarantees or legal obligations to individual patients.

Benchmark Priority Areas

Provinces and Territories agreed to these national evidence-based benchmarks in December 2005.

Service Area Pan-Canadian Benchmarks
Curative Radiotherapy Within 4 weeks (28 days)
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)
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)
Hip Fracture Repair Fixation within 48 hours
Breast Screening Women aged 50-69 every two years
Cervical Screening Women, starting at age 18, every three years to age 69 after two normal pap tests.

Benchmark Categories: Definitions and Locations to Access these Services

Radiation Therapy (Radiation Treatment)

Radiation therapy is the use of a certain type of energy (radiation) from X-rays, gamma rays, electrons and other sources to destroy cancer cells. In high doses, radiation destroys cells in the area being treated. It does this by damaging the DNA in cancer cell genes, making it impossible for them to grow and divide. During radiation therapy, both cancer cells (which are growing in an uncontrolled way) and healthy cells are affected, but most healthy cells can repair themselves afterwards.

Where will I be referred to have this treatment?
The Provincial Cancer Care Program is located at the Dr. H. Bliss Murphy Cancer Centre, Eastern Health, in St. John’s.

Coronary Artery Bypass Graft Surgery (Open Heart Surgery)

Coronary artery bypass graft surgery (CABG), or open heart surgery, is a surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient’s own arteries and veins located in the leg, arm, or chest.

Where will I be referred to have this surgery?
Patients needing this highly specialized surgery will be referred to the Provincial Cardiac Care Program located in the General Hospital – Health Sciences Centre, Eastern Health, in St. John’s.

Total Hip Replacement Surgery

A hip replacement (total hip replacement) is an orthopaedic surgical procedure in which the hip joint is replaced with man-made devices called prostheses. Replacing the hip joint consists of replacing both the ball (acetabulum) and the socket (femoral head).

Where will I be referred to have this surgery?
Ask your orthopaedic surgeon where you are having your hip replacement surgery, as this procedure is performed in the following hospitals:

Eastern Health
General Hospital – Health Sciences Centre – St. John’s
St. Clare’s Mercy Hospital – St. John’s

Central Health
James Paton Memorial Hospital – Gander

Western Health
Western Memorial Regional Hospital – Corner Brook

Labrador – Grenfell Health
Charles S. Curtis Memorial Hospital – St. Anthony

Total Knee Replacement Surgery

A knee replacement (total knee replacement) is an orthopaedic surgical procedure in which the end of your thigh bone (femur), the top of your shin bone (tibia), and the back of your kneecap are replaced with man-made parts called prostheses.

Where will I be referred to have this surgery?
Ask your orthopaedic surgeon where you are having your knee replacement surgery, as this procedure is performed in the following hospitals:

Eastern Health

General Hospital – Health Sciences Centre – St. John’s
St. Clare’s Mercy Hospital – St. John’s

Central Health

James Paton Memorial Hospital – Gander

Western Health

Western Memorial Regional Hospital – Corner Brook

Labrador – Grenfell Health
Charles S. Curtis Memorial Hospital – St. Anthony

Cataract Surgery (Sight Restoration)

Cataract surgery is the removal of the cataract and implantation of an artificial lens to correct vision loss. A cataract is a small cloudy area in the lens of the eye that blocks the passage of light to the retina. The condition usually affects both eyes, but almost always one eye is affected earlier than the other.

Where will I be referred to have this surgery?
Ask your eye specialist (ophthalmologist) where you are having your cataract surgery done, as this procedure is performed in the following hospitals:

Eastern Health
General Hospital – Health Sciences Centre – St. John’s
St. Clare’s Mercy Hospital – St. John’s

Central Health
James Paton Memorial Hospital – Gander
Central Newfoundland Regional Health Centre – Grand Falls-Windsor

Western Health
Western Memorial Regional Hospital – Corner Brook
Sir Thomas Roddick Hospital – Stephenville

Labrador – Grenfell Health
Charles S. Curtis Memorial Hospital – St. Anthony – provided by a visiting specialist

Hip Fracture Repair Surgery

A hip fracture is the same as a broken hip. Hip fracture surgeries are procedures performed by an orthopaedic surgeon to repair a break in the upper part of the thigh bone. The thigh bone is called the femur, and it is part of the hip joint. Patients are not placed on a wait list for this urgent operation.

Where will I be referred to have this surgery?
Ask your orthopaedic surgeon where you are having your hip fracture repaired, as this procedure is performed in the following hospitals:

Eastern Health
General Hospital – Health Sciences Centre – St. John’s
St. Clare’s Mercy Hospital – St. John’s

Central Health
James Paton Memorial Hospital – Gander

Western Health
Western Memorial Regional Hospital – Corner Brook

Labrador Grenfell Health
Charles S. Curtis Memorial Hospital – St. Anthony

Wait Time Access Targets – Frequently Asked Questions (FAQs)

What are wait time or access targets?

Wait time or access targets represent the optimal length of time in which patients should be treated. Targets are developed by using expert opinion and sound clinical advice, and are used in circumstances when scientific evidence is insufficient to recommend benchmarks.

What are Multi-Year Wait Time Access Targets?

Multi-year targets are interim goals to guide our progress towards achieving the benchmarks. Provinces and territories agreed to set multi-year targets with the announcement of the national evidence-based benchmarks in December 2005. The Department will be working with stakeholders and clinical experts to develop wait time access targets that physicians, care providers and administrators can work towards. They will be added to the website as they are developed.

Patient Wait Time Guarantee – Frequently Asked Questions (FAQs)

What is a Patient Wait Time Guarantee?

A patient wait time guarantee is a commitment that patients will receive treatment for a medically necessary health care service within a maximum acceptable timeframe. If the system fails to deliver treatment within the defined timeframe, access to alternative care options (recourse) will be automatically offered to the patient. In the event that wait time is exceeded, it will be the patient’s decision to accept the alternative care options proposed or to continue to wait.

What wait time guarantee is in place for the citizens of Newfoundland and Labrador?

All provinces entered into guarantees with the Federal Government a few years ago. In this province, the guarantee for cardiac bypass (open heart) surgery came into effect on March 31, 2010. In this situation, patients are guaranteed to undergo cardiac bypass (open heart) surgery within 182 days of being placed on the wait list. By entering into this Wait Time Guarantee Agreement with the Federal Government, we are guaranteeing that Newfoundlanders and Labradorians will receive access to cardiac bypass surgery within the national target of 182 days, and that we will provide alternate treatment options, such as the option to access surgery in another jurisdiction/elsewhere, in the event that patients are waiting longer than 182 days.

Will patients be forced to travel out-of- province to undergo open heart surgery within 182 days?

The cardiac care team is working hard to ensure patients will have their surgery done within the recommended time. In the unlikely event that the wait time exceeds 182 days, patients will be offered the opportunity to have their operation completed at a facility outside the province. The cardiac care team and surgeons will work with individual patients to discuss the appropriate treatment options. Patients have the right to refuse recourse. If a patient chooses to wait longer to undergo treatment here, then we will have to respect their informed decision. In the meantime, we will continue to work to decrease their wait time.