Thunder Bay Regional Health Sciences Centre reduces cancer surgery wait times.

February 8, 2006

Building on Tuesday’s announcement of the highly anticipated Ontario Cancer Plan Progress Report launched by Cancer Care Ontario (CCO), Regional Cancer Care at the Thunder Bay Regional Health Sciences Centre (TBRHSC) today announced the Regional Cancer Plan for Northwestern Ontario. These brand new comprehensive plans will address the gaps in cancer care across the province and our region, including continuing to improve upon the already dramatically reduced wait times for cancer surgeries in our region.

One of the key messages from Tuesday’s launch heralded the 16% drop in radiation wait times across the province, through expanded services and new capital projects. In Northwestern Ontario, where the median wait times for radiation are the shortest in the province, Regional Cancer Care is celebrating the dramatic turnaround in wait times for cancer surgeries, consistently reporting in the top ten across the province, with a respective first and second for breast and colorectal cancer surgery median wait times.

Additionally, in early 2005, median wait times for an MRI were within approximately 365 days; they are now approximately 27 days, and CT waits have dropped to approximately a 4 day wait, positioning TBRHSC as second in the province. Due largely to the planning and strategies that came out of the Ontario Cancer Plan for Northwestern Ontario, the wait times for cancer surgery and the MRI and CT diagnostic procedures have been reduced through additional equipment, provincial support, better allocation of resources, and a focus on the gaps in cancer care across the spectrum of care. “In an area like Northwestern Ontario, the overarching challenges of awareness, education, access and geography are the main reasons for the excitement behind our Regional Cancer Program and the continuing improvements. We have close to 300,000 residents in Northwestern Ontario over a vast area, which translates into 2% of Ontario's population on more than half of its land mass," commented Michael Power, Vice President of Regional Cancer and Diagnostic Services. "One third of our population is Aboriginal, with limited access to full service cancer care. Additionally, in those communities, there exists a cultural barrier of language, awareness and education, so our challenge is threefold. Through the exhaustive investigations of our Plan secretariats, we are finding that we are making unprecedented progress in these areas."

“After one year, the Ontario Cancer Plan is already improving our ability to detect and treat cancer, but more needs to be done to manage burgeoning cancer rates,” said Dr. Terry Sullivan, president and CEO, Cancer Care Ontario. “The province’s cancer care plan is on the right track. Our job now is to continue to improve the standard of cancer care, make targeted investments to reduce wait times and meet patient needs, and put a major effort behind cancer prevention and screening.”

CCO has drilled down into six priorities for action in the Plan, to improve the quality of cancer services for patients and to realize the full potential of prevention and screening.

1. Better quality – Cancer Care Ontario has created new clinical guidelines for cancer screening and treatment, and produced the first organizational standards for colorectal and lung surgeries. As part of the government’s Wait Time Strategy, funding for hospitals has been tied to better information and quality improvements for cancer surgery; In Northwestern Ontario, Palliative Care Lead appointed December 2005 for palliative care regionally and within the TBRHSC; Pathology Reporting Checklist (CAP); Disease Site Secretariats created in Breast, Colon, Prostate, Gynaecologic and Lung – organizational and regional indicators of performance developed along with a series of qualitative challenges in each disease site area.
    
2. Better local accessibility – Regional Cancer Programs were created to link together care providers, patients and decision makers to coordinate and improve local cancer services. There are now 14 Regional Cancer Programs linked to the Local Health Integration Networks (LHINs) that are working to improve local cancer services so that every Ontario patient has access to an equally high quality of cancer care, as close to home as possible; In Northwestern Ontario, 5 Disease Site ‘secretariats’ created with numerous challenges identified for the operational networks to assess and act upon, and metrics created to monitor performance; ‘Operational Networks’ created in eight areas (Prevention, Screening, Diagnostics, Surgery, Systemic, Radiation, Palliative, Survivorship).
    
3. Better services – There has been important progress in detecting cancer early and meeting patients’ care needs, but more needs to be done to close the gap between demand for cancer care and the province’s capacity to provide services; In Northwestern Ontario, All Cancer 20/20 targets aligned with disease site secretariat recommendations, regional 2008 targets created, regional prevention network created, further integration with Public Health; New Public Health “Tobacco” Manager to join the RCP team; 5 new smoking control by-laws mentored by “our” Tobacco Free Coalition; Colorectal Cancer Screening “preparation” program being developed by the Screening Network; Growth in breast screening (new affiliates like TBRHSC, annual screens); Aboriginal Cancer agenda grows – Aboriginal Cancer Committee working on smoking control by-laws for on-reserve communities; Post Construction Operating Plan (PCOP) funded ($1.188M); New capital projects to support cancer patients complete: 2nd MRI, new Lodge, new breast health assessment centre; Intensity Modulated Radiation Therapy (IMRT) go-live in 2006, High Dose Rate Brachytherapy (HDR) Prostate go-live 2006, Magnetic Resonance Imaging (MRI) Spectroscopy go-live 2006; Full complement of radiation, systemic, general practitioners in oncology (GPO), and cancer surgeons.
    
4. Better care – The government’s Wait Time Strategy investments have resulted in better access to cancer surgeries, better information to manage wait times, and lasting improvements in the quality of cancer services in Ontario. Government-funded innovation projects have generated new ideas to improve access to cancer care; In Northwestern Ontario, Median wait time recommendations met in MRI, CT, radiation, systemic and all cancer surgery areas in 2005/06; New wait times performance office put in place (regionally) and managed by the Integrated Cancer Program; New decision support tools created in all cancer care areas (to align with new regional indicator development); New Centre for Breast Screening & Assessment go-live March 23rd.
    
5. Better information – Cancer Care Ontario now has information management tools in place to promote accountability, and to manage better cancer system performance and report to providers and the public about cancer services; In Northwestern Ontario, Introduction of Cancer System Quality Index (CSQI), Cancer 20/20, regional indicators to baseline and track performance in each key area; ‘Communities of practice’ model in place in surgery – ie: first colon cancer surgeon (November 2005) funded to take an in-depth laparoscopic colon cancer surgical improvement program (Dr. G. Mapeso); Picture Archiving Communications System (PACS) and Electronic Medical Record (EMR) integration (pan-northern strategy); Electronic medical systems integration now being studied for September 2006 deadline; Manager of Cancer System Performance in place – active pilot project users of the system performance life cycle.
    
6. Better research – Cancer Care Ontario has restructured and fortified its research efforts, creating research networks in four key areas that support CCO’s priorities: patterns of cancer care, experimental therapeutics, improved cancer imaging, and the link between molecular factors and cancer in the population; In Northwestern Ontario, RCP Northwest aligned with Cancer Care Ontario research themes, with Molecular Imaging an area of key interest; New joint venture with Sunnybrook & Womens Research Institute (SWRI) being explored to create a “Centre of Excellence”; New Cancer and Cardiac Research Institute to be birthed in 2006; Active member of Mayor’s Health Sector Task Force; ICR Discoveries: 21 PHD Cancer Researchers collaborating in Northwestern Ontario ($600K in annual research grants); NOSM/TBRHSC sign new research agreement; New corporate strategic plan for TBRHSC (research an area of focus); First animal research lab in Northwestern Ontario.

CCO is the provincial umbrella organization that steers and coordinates Ontario’s cancer services and prevention efforts, setting standards of care through evidence based guidelines and initiatives to address the burden on cancer in Ontario. In 2003, CCO identified that there were fundamental areas in the continuum of cancer care that needed greater strategic direction and improvement, and initiated a plan that would impact cancer care across every region. During this time, it has worked with all of the cancer centres across the province to collect information on all of the regions in Ontario to determine gaps in the cancer systems. This Ontario Cancer Plan incorporates provincial initiatives like the Cancer Quality Index and Cancer 2020, providing a blueprint for cancer care, and ensuring the data is applicable to determining the highest standards of care for any cancer patient across Ontario.

Click here to view the complete Ontario Cancer Plan 2005 Progress Report

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