Average-cardiac-wait-time-2 - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Average time patients waited before they underwent a cardiac surgery or procedure

Alternate Name

Average wait time for a cardiac surgery or procedure

INDICATOR DESCRIPTION

Description

This indicator measures the average time patients waited for a cardiac surgery or procedure. Wait times were calculated from the day the patient and doctor decided to go ahead with the surgery or procedure, to the day the surgery or procedure was performed. A lower value is better. The wait time is reported for each priority level. Patients are assigned a priority level for surgery or procedure based on their clinical assessment. The indicator is reported based on the institution where the surgery or procedure took place.

There are three cardiac surgeries or procedures reported Online:

1.A diagnostic cardiac catheterization (CATH), or angiography, is a catheter based diagnostic test that involves selectively injecting x-ray contrast dye into one or more coronary arteries in order to visualize blockages in the arteries and vessels that supply blood to the heart.

2.A percutaneous coronary intervention (PCI), or angioplasty, is a procedure that involves using a catheter to insert a stent that opens blocked blood vessels in the coronary arteries.

3.Coronary artery bypass graft (CABG) is a surgical procedure performed on patients with coronary artery disease to bypass areas of blockage. Blood vessels, most commonly from the legs or chest wall, are grafted onto the heart to allow blood to flow past diseased heart vessels

HQO Reporting tool/product

Public reporting

Dimension

Timely

Type

Process

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Days

Calculation Methods

Average or mean

Average time for adults who underwent the cardiac surgery or procedure that were done in the reporting period within Ontario's 19 advance cardiac service hospitals and met the inclusion criteria.

Inclusions:

1. Static (month-end) Data.

2. Must be onlisted and offlisted as that procedure: Onlisted and offlisted refers to being put on the waiting list. Once a patient sees a specialist (cardiologist, cardiac surgeon) and that physician accepts the patient for a procedure (CATH, PCI, CABG) they are "onlisted" to the wait list. Once the patient receives their treatment and the procedure is over the patient is "offlisted" from the wait list (because the treatment is done).

3. Wait time takes into account DART* per patient.

DART stands for Dates Affecting Readiness to Treat. It means that a wait list clock is paused because the patient asked the physician to pause it. There is no limit to the number of DARTS that can be applied to a surgery. If a patient changes priority, the wait time clock is restarted against the target for the new priority.

Exclusions:

1.Patients who die before they receive their procedures

Numerator (short description i.e. not inclusions/exclusions)

Denominator (short description i.e. not inclusions/exclusions)

Adjustment (risk, age/sex standardization)- generalized

None

Data Source

CorHealth Ontario

Data provided to HQO by

CorHealth Ontario

Reported Levels of comparability /stratifications (defined)

Corporation, Priority level, Province, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

1. This wait time is collected for patients who have undergone this surgery. That is, patients who are still waiting are not included in the calculation. 2. This wait time is reported not at the surgeon level but rather at the level of the facility where the procedure took place. 3. Cardiac service hospital with small volumes will be more severely impacted by extreme waits (particularly the average wait time). For example, an unusually long or short wait time for a single patient in a reporting period for hospitals will have a greater impact on the average. 4. Certain components of wait times may be difficult to capture. For example, the “decision to treat” date data element has a less standardized definition which may be open to some interpretation.