Hip, knee replacement wait times slashed

Not long ago, patients needing hip replacements at The Ottawa Hospital faced the longest waits in the province. The wait for those who needed new knees wasn’t much shorter.

But that has changed dramatically in the past six months, according to the latest data posted to the government of Ontario’s wait times website.

As recently as this past July, the wait time for a hip replacement at The Ottawa Hospital was 460 days. The figure reflects the point at which 90 per cent of patients have completed surgery. But that number has been falling rapidly ever since and in January reached 174 days — below the provincial average of 196 days.

The improvement has been almost as striking for patients getting knee replacements, who faced waits of as long as 434 days last July. Now, The Ottawa Hospital is completing 90 per cent of its knee replacement operations within 219 days, just four more than the provincial average.

Many patients actually get their hips and knees replaced much more quickly than the provincial wait time figures suggest. Half of all hip replacements at The Ottawa Hospital are now being done in 70 days or less. A year ago, the comparable figure was 149 days.

For knees, half are completed with 88 days. That’s up from 75 days in December, but still 60 days fewer than a year ago.

Despite the significant improvements, The Ottawa Hospital still has a way to go before it can challenge the wait times of the province’s best-performing hospitals.

For example, the University Health Network — which includes the Toronto General, Toronto Western and Princess Margaret hospitals — manages to complete 90 per cent of its hip and knee replacement operations within 76 days. And 90 per cent of patients who need new knees at Toronto’s Mount Sinai Hospital get them in nine days or less.

Locally, wait times for hip- and knee-replacement operations at the Queensway-Carleton and Montfort hospitals are also shorter than at The Ottawa Hospital, though the gap between them has closed substantially.

Dr. Paul Beaulé, the hospital’s head of orthopedic surgery, credits changes in the way the flow of surgical patients is managed for much of the wait time improvement.

In the past, family doctors would refer patients with knee or hip problems to surgical specialists, who would eventually see them and book times for their operations. “That obviously does not permit a lot of co-operation between various surgeons and operative sites,” Beaulé said.

Now, a central clinic assesses potential surgical patients and assigns a date for surgery before they visit their surgeon, he said. “That really ensured that all the resources of the day of surgery were used and patients were appropriately triaged, minimizing cancellations and medical work-ups.”

The Ottawa Hospital’s partnership with Kemptville General Hospital, which handles hundreds of less-complicated knee replacements a year, also forced it to think through its processes, Beaulé said. “The flow and timeliness are better managed because of that.”

Beaulé is impressed by the 76day wait time at Toronto’s University Hospital Network institutions. “Those are fantastic numbers,” he said, though he points out that Toronto’s large pool of surgeons “surely helps them have those very good numbers.” The Ottawa Hospital may be that low some day, he said, but for now, it is content to be within the provincial average.

With the provincial Ministry of Health switching to a system that provides extra funding to hospitals whose procedures rank highly on quality measures, it’s more important than ever not to be a laggard, Beaulé said.

The Ottawa Hospital wants to be a top performing institution in all areas “to compete for those health-care dollars that are going to be a bit more difficult to find in the future,” he said.