Manitoba Wait Time Information

UNDERSTANDING WAIT TIME DATA

Introduction

The data on this website is the most current and accurate information available on wait times in Manitoba. Data has been supplied and verified by regional health authorities (RHAs) and compiled by Manitoba Health Information Management. The data collected does not include personal information on either patients or physicians.

Wait time data, wherever possible, is provided at the level of the facility for the previous month, measured in weeks (median). Work is ongoing to standardize data and data reporting guidelines across programs and regions.

Data Sources

RHAs are required to report wait time data for services funded by Manitoba Health. Facilities collect information from physicians and from operating room or scheduling systems. This information is verified by RHAs before being sent to Manitoba Health Information Management.

No confidential patient data is collected, therefore current data collection processes do not allow for an audit trail back to the original source of the data in the physician's office or a facility’s scheduling system. As a result, an error in data entry or transcription could have an effect on the wait times reported for a particular facility. Every effort is made to ensure data accuracy.

Data Codes

There are situations that may result in no data being available for a given month for a given facility or region. These situations are identified in the data tables as follows:

N/C = Non-compliant
This means that the RHA did not report required information by the deadline for publication on this website.

C/V = Confidential volume
This means that the RHA reported less than 5 cases. To protect patient privacy, small volumes are not reported.

N/S = No service provided
This means that although available, none of these services were performed during this period in the RHA.

What is included, what is not included

In general, wait time data reported on this website are for non-emergency cases only (i.e. elective cases that are scheduled in advance). Situations where patients receive care through the emergency department of a hospital or otherwise require immediate treatment for a life-threatening condition are generally excluded from the wait time data.

Cardiac wait time data is reported according to three priority levels based on urgency, as determined by physicians:

Emergent and Urgent (Priority Level 1 – within 14 days)

These are critically ill, medically unstable patients, who cannot be discharged from hospital prior to receiving care.

Semi-Urgent (Priority Level 2 – within 15-42 days)

These are patients with significant heart health problems. They may be doing poorly on medication and/or may have pain with minor exercise. These patients are not critically ill but waiting too long could result in a deterioration in their health status.

Elective (Priority 3 – within 43-180 days)

These are patients who are stable but have some form of heart health problem. Their procedure may be scheduled after a wait time without undue deterioration in their health status.

How wait times are measured

How wait times are calculated can depend upon the type of information systems that are available.

Wait times on this website are based on cases completed during the reported month. The exception is in diagnostic services.

Diagnostic services wait times are not based on completed cases. The wait times are estimated based on the next available slot in the schedule.

As a result, diagnostic wait times are reported as estimated maximum wait times rather than averages or medians. In most cases patients typically wait much less than the reported wait time, very few patients may wait longer. As planned improvements in information systems for diagnostic services are implemented, diagnostic wait times will be standardized with other program areas and be reported in terms of the median wait time for completed treatments.

Median Wait Time vs Average Wait Time

Median wait time: The point at which half the patients have had their treatment, and the other half are still waiting. For example, if a median wait time is 4 weeks, this means that half of the patients waited less than 4 weeks, and half waited more than 4 weeks. The median is another way of reflecting what a "typical" patient might have experienced in that time period. Unlike the average, the median is not generally influenced by one or two very unusual cases (long or short), and is therefore more stable over time.

Average wait time: The average length of time a patient waited to have their treatment. The average wait time is calculated by dividing the total number of waiting days that the RHA reported, by the total number of treatments reported during the time period. This wait time may be dramatically affected by a few cases which had extremely short or long wait times.

In some circumstances, there may be a significant difference between the median and average wait time for a specific treatment. This is due to the fact that the average wait time can be dramatically influenced by a few cases that are very long or very short wait times. This skewing effect becomes greater if the total number of cases being measured is relatively small. Using the median to measure wait times reduces this skewing, and better reflects how long the "typical" patient will likely wait.

Factors Affecting Wait Time Data

Many factors that affect wait times are unrelated to the availability of resources or the efficiency of a particular facility. They include:

Variability

Wait time data is quite variable and can change dramatically from month to month. Over time the measure of wait times often looks like this:

Small Volumes

The wait times information that is reported often show big differences between RHAs in how long patients have waited for services. It is important to note that a wait time calculation based on a very small number of patients over a very short period of time can be misleading, since a few patients with unusually long or short wait times may have a very large influence on the results for that month (particularly the average wait time). In this situation, a hospital might have a single month with a very long average wait time while the usual wait times are much shorter, and the experience for most patients will be unchanged. The result is that the smaller the number of cases reported, the more difficult it is to draw conclusions about what should be expected.

This issue will particularly affect RHAs that do not treat many patients (for example a small hospital performing cataract surgery), as well as larger hospitals that perform very specialized surgery (for example, surgery for lung cancer).

Other Factors Affecting Wait Times:

• Patient Choice – a patient with a non-life-threatening condition may choose to delay treatment for personal or family reasons to a more convenient time.
• Patient Condition – treatment may be delayed until a patient’s condition improves sufficiently that surgery or a test can be performed.
• Follow-up Care – a patient with an existing condition may be pre-booked for a follow-up treatment or test to monitor changes in patient condition.
• Treatment Complexity – specific resources may be required for a patient with special requirements, resulting in a delay until these can be scheduled.

Wait Time Access Targets

Provinces and territories agreed to national evidence-based benchmarks in December 2005 (with the exception of diagnostic services, to follow in 2006). Manitoba is working with stakeholders and clinical experts to develop wait time access targets that patients, care providers and administrators can use to monitor progress. As data standards are developed, Manitoba will be adding these elements to the website.