Toronto’s Hospital for Sick Children has been trying new, innovative approaches to get its backlogs under control to reduce waiting times for surgery, diagnostic assessments and specialist appointments – and the efforts are starting to bear fruit.
Children and teens across Canada still face long waits, a reality that was exacerbated by the pandemic and is putting the long-term health of many pediatric patients at risk. But this month, the number of children waiting for surgery has fallen below 6,000 for the first time since November, 2022.
While 6,000 is still an “unacceptable” number, Abhaya Kulkarni, who took the helm as surgeon-in-chief last month said it represents an important 10-per-cent reduction in the past nine months and a sign that things are slowly improving.
“It does look like it’s a slow, but continuing, trajectory,” Dr. Kulkarni said. “It’s the first time that we’ve had this type of good news in a long time.”
A lot of the success, he says, can be attributed to a new program SickKids has developed in partnership with six hospitals around the Greater Toronto Area. Under the partnership, SickKids staff comb through the surgical waiting list to identify less complex cases as well as pediatric patients on the waiting list for an endoscopy, a procedure that involves using a scope to look inside a person’s body. Those cases that are deemed to be more straightforward are sent to one of the partner hospitals, allowing SickKids staff to focus on the complex procedures that can only be performed there.
Since the program began last spring, SickKids has referred nearly 700 cases to its partner hospitals, the majority of them completed as of mid-May.
“I think really seeing how all of these hospitals have come together at a systems level to address the pediatric surgical wait list has been, I would say, inspiring to be part of,” said Jessica Ivan, manager of surgical community partnerships at SickKids. “I think we’ve come a long way and we still have a long way to go.”
All of the cases are individually reviewed and carefully examined to ensure that they should be referred, Ms. Ivan said.
Another approach that has led to the decrease is the hospital’s weekend surgery initiative. Typically, the operating rooms at SickKids take on elective, non-urgent surgeries during the week, with weekends reserved for emergencies. But hospital staff realized that if they opened up available operating rooms on weekends to the less-urgent cases, they could make a real difference in the number of children waiting for their procedure.
Dr. Kulkarni said they’ve performed 320 procedures under the weekend program.
A national children’s health advocacy organization is pushing the federal government to create a new officer to help establish targets and timelines to ensure that the pediatric population has timely access to the care they need.
“Health outcomes for children in Canada are worsening, year over year,” said Emily Gruenwoldt, president and CEO of Children’s Healthcare Canada, in a statement. We have a moral and financial imperative to take action to reverse this trend, for our kids, and for our collective future.”
Children’s Healthcare Canada has been at the forefront of efforts in recent years to “right-size” the pediatric health care system, referring to the fact that the number of pediatric beds has fallen dramatically in recent decades and that children are typically waiting longer for surgeries and many other procedures than adults.
For instance, a report from the organization released last fall found that 40 per cent of pediatric scoliosis patients are waiting longer than clinically recommended, which could have lifelong ramifications.
Pediatric experts note a similar trend for other areas of child health, including long waiting times for autism assessments, inequitable access to mental-health supports and backlogs for specialist appointments, all of which pose barriers to ensuring those patients can reach their maximum developmental potential.