Nova Scotia still far behind in wait times for hip, knee surgeries: auditor

Click to play video: 'Auditor General Report gives NSHA failing grade'
Auditor General Report gives NSHA failing grade
WATCH: Despite a record high reported percentage of completed recommendations the Auditor General's 2014-2015 follow up report shows the Nova Scotia Health Authority is still lagging behind in surgical wait times. Jeremy Keefe reports – Apr 3, 2018

Nova Scotia’s main health authority has failed to implement several recommendations from 2014 aimed at improving surgical wait times, the province’s auditor general said Tuesday.

Michael Pickup released a follow-up report to recommendations released in 2014-15, finding the Nova Scotia Health Authority has a completion rate of 44 per cent from two audits.

READ MORE: N.S. admits knee, hip surgery wait times are still longest in the country

He said the authority has not satisfied five of seven commitments on surgical wait-time reporting and operating room usage, noting that wait times for hip and knee replacements far exceed the national benchmark.

On average, people in the province wait a year and a half for the surgeries – excluding the waiting time for a referral appointment with a surgeon – compared with the national benchmark of six months.

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“Nova Scotia Health Authority management told us it is working to improve surgical wait times and operating room use across the province, and have a detailed plan to reduce hip and knee replacement wait times to meet the national six-month wait time target by 2020,” Pickup said in a statement.

“We encourage the Nova Scotia Health Authority to complete its actions, and publicly report on how and when surgery wait times will improve, including the significant wait-time target reductions needed to make their 2020 goal.”

To get there, the authority has said it plans to recruit surgical staff and set up assessment clinics to co-ordinate care and wait lists.

Colin Stevenson, the authority’s vice-president of quality, said the organization had to contend with the provincial government’s decision to amalgamate nine regional health boards in 2015.

WATCH: Nova Scotians waiting too long for hip & knee replacements: AG

“We’re not quite where we want to be yet, but we are making some progress around improving what our wait-times are,” he said in an interview.

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“Some of it is tied to the fact that we merged as an organization and switched our focus from what the individual health authorities may have been doing to … establishing ourselves as a provincial program.”

In his report, Pickup said the health authority had not yet set “specific, short-term wait time performance targets” or developed elective surgery wait time reporting processes, which help identify what can be done to deal with long wait times.

Again, Stevenson said more time was needed to achieve those goals.

“It takes a bit of time to get people to think around where alignments can be had,” he said. “It may not be as quick as what the auditor general would like to have seen. But we think we’ll be in a better place in the end.”

Pickup said the authority had also not followed through on a recommendation to update operating room policies regarding physician absences, surgery cancellations and operating room time allocation to make it more efficient.

But, the auditor general said the government overall is doing well in implementing recommendations from the previous audits. He said the province has an overall completion rate of 75 per cent – its highest yet and an improvement from its 53 per cent rating in 2014.

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Pickup found 160 recommendations out of 213 have been completed, with 12 out of the 28 organizations completing all of the requested actions.

“I am encouraged by the 12 organizations in government that completed 100 per cent of their promised actions, and the leaders of those organizations can be proud of this achievement,” he said.

He said four organizations, including the Conseil scolaire acadien provincial, Housing Nova Scotia and the office of Aboriginal Affairs, had completion rates less than 60 per cent.

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