Pediatric surgical capacity and demand: analysis reveals a modest gap in capacity and additional efficiency opportunities

Abstract

The Canadian Paediatric Surgical Wait Times Project conducted an analysis of the alignment between capacity (supply) and demand for pediatric surgery at nine participating hospitals in five provinces. Demand for surgery was modelled using wait list data by assigning patients into monthly buckets of demand ("demand windows") based on the date on which a decision was made to proceed with their surgery plus their surgical wait time access target. Demand was then related to available capacity for various key resources (e.g., operating room availability, intensive care unit [ICU] and in-patient beds). The results indicate a small and not insurmountable gap of 8.5-11% in pediatric surgical capacity at these hospitals. A further capacity issue at many hospitals was ICU occupancy. In addition, an examination of several key performance indicators related to the management of peri-operative resources indicated that opportunities exist for deploying existing resources more efficiently, such as increasing on-time starts and reducing cancellation rates for elective surgery.