"My Quality of Life is Not There. I'm Dying Here. I Cannot Take This Anymore." Exploring Patient Experiences With Surgical Wait Times in Otolaryngology: A Mixed Methods Study

Abstract

BackgroundNew patient referral models are needed to reduce long wait times for otolaryngology surgical procedures, such as a Single-Entry Model (SEM). However, patient perspectives about SEM in otolaryngology remain unexplored.MethodsIn this mixed methods study, a retrospective chart review was conducted to examine the times from referral to consultation (T1) and from consent to surgery (T2) for all elective otolaryngology surgical procedures at a large community hospital between 2020 and 2023. We then conducted journey mapping interviews with 10 patients and parents of pediatric patients who underwent otolaryngologic surgeries to understand their experiences of waiting for their own or their child's procedure, and perspectives on how an SEM might impact patient experiences. Data were analyzed using descriptive statistics and thematic analysis.ResultsWe identified that average wait times among 2414 elective (oncologic and non-oncologic) otolaryngology procedures often exceeded provincial target wait times. On average, oncology procedures had the shortest wait times (T1: 34 ± 47; T2: 101 ± 161 days), and otologic procedures had the longest (T1: 67 + 72; T2: 355 ± 285 days). While patients often did not wait as long to have a consultation with their surgeon, the time between consenting to and receiving surgery tended to drive wait time duration. Patients who had endured extended wait times experienced poor quality of life, worsening symptoms, and often worried about how long they would need to wait. Systems such as an SEM that could shorten wait times were generally well-perceived. However, patients emphasized the importance of trusting relationships with referring physicians and surgeons, which could be an enabling factor for implementing an SEM.ConclusionLong surgical wait times in otolaryngology are negatively impacting patients. A SEM could offer a way to improve patient experiences and outcomes.

Keywords: clinical research; health services; pediatrics; quality improvement; quality of life.

Graphical Abstract

Figure 1.

T1 and T2 wait times by procedure type. T1 = time from referral to first consultation with the surgeon; T2 = time from consent to surgery until the procedure occurred. Target wait times for non-oncologic T1: 182 days; T2: 182 days (2). Target wait times for oncology T1: 35 days; T2: 84 days (9). Red: Outside target waits times.