Beating the Backlog

Addressing long waitlists for surgery 

Nobody likes to wait – especially when it comes to surgeries that can impact one’s quality of life.  

“In terms of how many patients are waiting and how many surgeries were postponed because of the pandemic, estimates show that the numbers have doubled,” says  
Dr. David Urbach, Head and Medical Director of Perioperative Services at Women’s College Hospital (WCH) and Professor in the Department of Surgery at The University of Toronto.  

As a surgeon-scientist (which accounts for less than 2 percent of all surgeons in Canada), Dr. Urbach is no stranger to advancing health policy and improving patient care. At WCH, his team was responsible for creating Canada’s first program for same-day joint-replacement surgery in an outpatient setting.   

Now, he is working to reduce surgical wait times by collaborating with partner hospitals in Toronto. In doing so, he aims to address bottlenecks in the system and reduce the suffering of patients whose conditions may not be life-threatening, but still require attention.    

“The idea is to change from an independent, siloed model of care into a coordinated model of care,” says Dr. Urbach. “Surgeons [from different hospitals] can work together to care for patients through the use of a single-entry model.”  

When patients enter a single queue – instead of being put on separate wait lists at different hospitals – they can be seen by the next appropriate surgeon who becomes available. This system increases efficiency for surgeons and allows for the better allocation of resources, from nursing staff to surgical facilities.    

Dr. Urbach has already implemented this model to address the long waitlist of patients in need of surgical procedures for benign anorectal conditions such as hemorrhoids, anal fistulas and anal fissures.  

“The Toronto Anorectal Program (TARP) based at WCH has demonstrated that this model works really well,” he says. “The wait times are short and we’re addressing a type of care that’s needed to improve quality of life.”  

Ideally, this model can be adopted more broadly in the future to address surgical backlogs on a grander scale.  

“I derive a lot of gratification knowing that projects like this can shore up the Canadian health system, and we can restore public confidence in our system’s ability to ensure that people receive good care.” 

Dr. David Urbach, Head and Medical Director of Perioperative Services, WCH

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