Percentage of elective wait list patients waiting over boundary for reportable procedures
Rationale
Elective surgery refers to planned surgery that can be booked in advance following specialist assessment that results in placement on an elective surgery waiting list.
Elective surgical services delivered in the WA health system are those deemed to be clinically necessary. Excessive waiting times for these services can lead to deterioration of the patient’s condition and/or quality of life, or even death. Waiting lists must be actively managed by hospitals to ensure fair and equitable access to limited services, and that all patients are treated within clinically appropriate timeframes.
Patients are prioritised based on their assigned clinical urgency category:
- Category 1 – procedures that are clinically indicated within 30 days
- Category 2 – procedures that are clinically indicated within 90 days
- Category 3 – procedures that are clinically indicated within 365 days.
On 1 April 2016, the WA health system introduced a new statewide performance target for the provision of elective services. For reportable procedures, the target requires that no patients (0%) on the elective waiting lists wait longer than the clinically recommended time for their procedure, according to their urgency category.
To maintain a sustainable elective surgery waitlist, EMHS is also progressing several longer-term strategies, including:
- Dual site consultant led vascular service across Royal Perth Hospital and Armadale Hospital, inclusive of outpatient services and operating time.
- Progressing procurement of a non-orthopaedic surgical robot to support surgical staff recruitment and retention.
- Improving the pre-anaesthetic assessment model of care to optimise access, reduce cancellation and subsequently improve theatre efficiency.
- Expanding the surgical contemporary workforce model across particular specialties.
- Piloting virtual care applications to support early pre-surgical screening.
Target
The 2024-25 target for patients waiting over boundary for all urgency categories is 0 per cent. A result equal to target is desired.
Results
Click the drop-down arrow to see different KPI categories
Category 1
| Year | Target | Actual | |
|---|---|---|---|
| Years 2024-25 | Target 0% | Actual 8.7% |
|
| Years 2023-24 | Target | Actual 7.3% |
|
| Years 2022-23 | Target | Actual 11.9% |
|
| Years 2021-22 | Target | Actual 6.5% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2024-25 | Target 0% | Actual 35.9% |
|
| Years 2023-24 | Target | Actual 33.4% |
|
| Years 2022-23 | Target | Actual 38.5% |
|
| Years 2021-22 | Target | Actual 28.3% |
|
| Year | Target | Actual | |
|---|---|---|---|
| Years 2024-25 | Target 0% | Actual 11.4% |
|
| Years 2023-24 | Target | Actual 10.8% |
|
| Years 2022-23 | Target | Actual 15.8% |
|
| Years 2021-22 | Target | Actual 9.3% |
|
Commentary
In 2024-25, EMHS did not meet the elective surgery recommended target for any urgency category.
Challenges impeding EMHS’ ability to meet the elective surgery targets include demand exceeding theatre and inpatient bed capacity. In addition, ongoing workforce attraction and surgical preparatory pathways remain the key challenges and are an ongoing priority for EMHS.
Several actions were progressed to improve the elective surgery waitlist in the 2024-25 financial year:
- Outsourcing surgical services privately to support meeting high demand with a focus on orthopaedics, general surgery and urology.
- Additional theatre lists including weekend elective operating lists.
- Procurement of an orthopaedic surgical robot to support staff retention and recruitment.
- Consolidation of a tiered referral endoscopy network across EMHS sites to deliver endoscopy care in a timely manner and alleviate demand for tertiary theatres.
- Virtual care and early discharge via EMHS Hospital in the Home team.
To maintain a sustainable elective surgery waitlist, EMHS is also progressing several longer-term strategies, including:
- Dual site consultant led vascular service across Royal Perth Hospital and Armadale Hospital, inclusive of outpatient services and operating time.
- Progressing procurement of a non-orthopaedic surgical robot to support surgical staff recruitment and retention.
- Improving the pre-anaesthetic assessment model of care to optimise access, reduce cancellation and subsequently improve theatre efficiency.
- Expanding the surgical contemporary workforce model across particular specialties.
- Piloting virtual care applications to support early pre-surgical screening.
Period: 2021-22 – 2024-25 financial years (average of weekly census data)
Contributing sites: Armadale/Kelmscott District Memorial Hospital, Bentley Hospital, Kalamunda Hospital, Royal Perth Hospital, St John of God Midland Public Hospital (public
patients)
Data source: Elective Services Wait List Data Collection
Outcome one // Effectiveness KPI