New approach to scheduling surgeries and endoscopies helps reduce wait times and improve patient communication and satisfaction

Members of the Eastern Zone centralized surgical booking team at their Membertou Office

When nearly record-breaking snowfalls disrupted travel and healthcare operations in Cape Breton last winter, a new Nova Scotia Health team was able to quickly notify surgical and endoscopy patients their procedures were postponed and give them a new appointment for their peace of mind.

“That would never have been possible without our new centralized surgical booking approach, and was something both patients and surgeon offices appreciated,” said health services manager Alicia Leblanc, who manages the centralized booking team responsible for scheduling patients for procedures at Cape Breton hospitals and St. Martha’s Regional Hospital in Antigonish. 

“Centralized booking is helping us transform access for our patients. It improves communication with patients, helps us book more patients within the timeframe assigned by their surgeon, and supports our overall efforts to improve wait times, by validating waitlists, preventing cancellations and increasing the time spent delivering care in our operating and endoscopy rooms.”  

Nova Scotia Health launched the new booking approach last year to support faster care and better experiences for patients.  

With thousands of patients referred to surgeons each month, and many others waiting for their procedures, the goals are simple – better coordinate scheduling to help those who need care most urgently and those have been waiting the longest, receive care first, while making the best use of healthcare resources to improve access to care for all. 

Centralized surgical booking models were used at a few hospitals before, but teams have been working with specialists to expand these models to all sites that offer surgeries and endoscopies.  

Eastern Zone (Cape Breton, Guysborough and Antigonish Areas) was the first to fully roll-out the model, with their last service coming on-line in 2023. All zones will complete the roll-out by early 2025. 

Members of the Eastern Zone team say patients often express how much they appreciate knowing there is someone they can reach out to, and many surgeons and their office staff are providing positive feedback too.

“Central booking has streamlined access to surgery for Eastern Zone patients and maintains the flexibility to adjust to short-notice changes,” said Dr. Blair Williams, a head and neck surgeon and site head of surgery at Cape Breton Regional Hospital.

“Having the central booking team take on the effort of building patient lists and providing patients with instructions, has freed up administrative time for other tasks and the teams is responsive to rearranging lists or filling gaps when an urgent case comes up, or the patient is no longer available.”

Early results

While still in the early days, centralized booking, combined with standardized health history questionnaires (helps flag patients needing other tests or clinics before their procedure), is already credited with helping reduce the number of patients having their procedures cancelled the day of their appointment, and the percentage of patients waiting more than a year for surgery (long waiters).

• The year before the final rollout of centralized booking in Eastern Zone (August 2022 to July 2023) the average same day surgery cancellation rate for area hospitals was almost 11 per cent. This average dropped to seven per cent in the year after their launch and was down to 4.5 per cent this October.
• The number of long waiters on their surgical waitlists also dropped during that time, from a high of 21 per cent in January 2023 to 12 per cent at the end of October.
• Provincially, the percentage of long waiters was down to 16 per cent this October, compared to 23 per cent last October.

In Western Zone, where teams launched a cystoscopy service at Yarmouth Regional Hospital, they have found centralized booking makes it easier to schedule patients to see visiting specialists. 

“If a patient needed to cancel last minute, we couldn’t easily schedule another patient, which meant specialists sometimes travelled here and were not able to do as many cases as planned," said Gina Leaman, the zone’s interim director of Perioperative Services. 

"With centralized booking we can see other patients who are waiting and reach out to ensure the specialist sees as many patients as possible.”   

Over the last six months, the hospital’s same day cystoscopy cancellation rate averaged just over three per cent, compared to 10.9 per cent in the same six months last year. 

Transforming surgical access and care

Nova Scotia Health also launched electronic referrals in 2023 in response to growing needs and evidence that improved coordination of referrals to surgeons and the scheduling of procedures are key to addressing access challenges felt across Canada and globally. 

“Like other areas, Nova Scotia has been historically challenged to deliver surgeries and other procedures in a timely fashion, so as teams worked to recover from the pandemic and improve access, we knew a different approach was needed to achieve and maintain the results our patients need,” said Cindy Connolly, senior director of Nova Scotia Health’s Perioperative Services Network, which supports efforts to improve access and care.  

“It wasn’t enough to invest in doing more procedures, we had to look at patients’ entire journey of care. We have considered how we can improve our processes from the time a patient is referred, and a decision is made to have surgery, to their pre-operative care, surgery, recovery, follow-up care and even how we evaluate and learn from patient experiences and the outcomes of their care.”  

Learn more about this new booking approach and other efforts to transform surgical access and care.