Cancer Care Ontario honours Dryden hospital for shortest wait to see specialist, have surgery

New software, flexibility around operating room schedules and a reset of priorities for surgeons have earned the Dryden Regional Health Centre (DRHC) top honours from Cancer Care Ontario for having the shortest period in the province for people to see a specialist, receive a cancer diagnosis and have surgery.

"Patients are very anxious when they hear the word cancer, and we felt this category should be fast-tracked," said Dr. George Rabbat the current president of medical staff and a surgeon at the hospital in northwestern Ontario, about 350 northwest of Thunder Bay.

The Ministry of Health and the College of Physicians and Surgeons of Ontario have set a benchmark of 28 days from diagnosis to the start of cancer treatment.

Some surgeries occur within a day

"I felt that if we can make things happen quickly for cancer patients, we should and sometimes we operate within a day, or two," said Rabbat, who was the chief of surgery for the period covered by the award.

The entire hospital supports the initiative, including the anesthesia department and the operating room nurses, he said, adding "sometimes they even start a case.. and they know they're going to go overtime but they don't mind when it comes to cancer, and this was something the hospital was willing to do, even with our small budget."

The hospital has made several changes to speed up the process including switching to Novari booking software, which prioritizes patients and connects doctors' offices, the clinic and the hospital, flagging those cases requiring the most urgent care.

"What used to happen is that the referrals were sitting in cyberspace or not going straight to where they should, right away, so technology has helped us in terms of reducing those loopholes," said Rabbat.

We are looking at the referrals on a daily basis so this is not a clerk job anymore, this is a surgeon's job. Any suspicion for cancer gets seen quickly and we always leave some spots in our scheduling to fit in these patients,- Dr. George Rabbat, Dryden Regional Health Centre 

Specialists have also changed how they organize their day to ensure are aware of priority cases.

"We are looking at the referrals on a daily basis so this is not a clerk job anymore, this is a surgeon's job. Any suspicion for cancer gets seen quickly and we always leave some spots in our scheduling to fit in these

For instance, he said there is a fast-track formula for a person who presents with a highly suspicious symptom, such as rectal bleeding. Not only is the person seen quickly by the specialist, but their diagnostic procedures, such as a colonoscopy, are also sped up.

DRHC is a relatively small hospital, with about 18,000 emergency room visits per year. By contrast, the Thunder Bay Regional Health Sciences Centre records over 100,000 visits annually.

Being smaller may be an advantage, especially when it comes to flexibility.

"We have lots of room to shuffle cases around, depending on urgency," Rabbat said. "A lot of these cases, we do them at the end of the day, which may not be available to the Thunder Bay surgeons because their resources may be different."

Larger hospitals slowed by larger patient volume

Rabbat pointed out it may be easier to accomplish these targets, "when you're not dealing with a big volume."

"I think that if you're dealing with 100 cases to be booked, it's really hard to shuffle people around."

However, the Dryden experience does provide valuable lessons for all hospitals and surgeons, said Rabbat, noting they are hoping to transfer some of what they've learned to other surgeries, such as gallbladder operations.

You can hear the full interview with Dr. Rabbat on CBC's Superior Morning here.