Measuring Wait Times for Orthopedic Surgeries

Patients with emergency conditions (Priority 1) are seen immediately and are not included in wait times data. Priority levels 2, 3, and 4 are determined by surgeons, specialists, and other health care providers, based on clinical evidence, to guide treatment decisions and improve patient access and outcomes.

Wait times for orthopedic surgeries, including knee replacements and hip replacements, in Ontario are measured and reported for two periods: Wait 1 and Wait 2. Data excludes patients who did not have the surgery after their first appointment with a surgeon.

Time from referral to first orthopedic surgical appointment (Wait 1): How long patients wait from a surgeon or central intake office receiving the referral from the patients’ doctor, to the patients’ first orthopedic surgical appointment.

Time from decision to orthopedic surgery (Wait 2): How long patients wait from deciding with the surgeon to proceed with the surgery, to having the orthopedic surgery.

Metrics used for orthopedic surgery wait times, for priority levels 2, 3 and 4, and those three priority levels combined:

The average number of days patients waited. A lower number is better.
The median number of days patients waited (half of the patients waited fewer than this number of days and the other half waited longer). A lower number is better.
The 90th percentile number of days patients waited (90% of patients waited this number of days or fewer, while 10% waited longer). A lower number is better.
The percentage of patients seen, or treated, within the target time for the 90th percentile (the target time within which 90% of patients were seen or treated). A higher percentage is better.
The volume, or number of patients seen or treated during the month reported.

Priority level of patients’ condition	Clinical description	*Target time from patients’ first orthopedic appointment**	Target time** from decision to having orthopedic surgery
Priority 1	Surgery is urgently required to address significant joint derangement	Not included in wait times data reported	Patients have surgery within 1 week of decision (not included in wait times data reported)
Priority 2	High probability of disease/disability progression and morbidity affecting function	Patients see surgeon within 30 days of referral received	Patients have surgery within 7 - 42 days of decision
Priority 3	The progress of the disability or disease is moderate	Patients see surgeon within 90 days of referral received	Patients have surgery within 56 - 84 days of decision
Priority 4	Risk of disease progression impacting mobility/function	Patients see surgeon within 182 days of referral received	Patients have surgery within 182 days of decision