REGINA - Neurosurgery wait times, the AIMS implementation, and the situation with contracted special care homes were among the many items that came under the microscope in the latest report from Provincial Auditor Tara Clemett.
The 2023 Report - Volume 2 was tabled at the Legislative Assembly on Wednesday afternoon. While the report touched on a number of topics including leased agricultural Crown land, apprenticeship and trade certification, and topics impacting education and social services, it seemed like the various issues in health care -- ranging from long wait times to IT issues to employee absenteeism -- made the biggest headlines.
Here is a rundown of some of those headlines and major points coming from the latest auditor’s report.
AIMS payroll system projected costs $240 million
The provincial auditor continues to monitor the progress of the Saskatchewan Health Authority in implementing AIMS — the Administrative Information Management System. The SHA went live with AIMS in November 2022, but the unsuccessful rollout caused the SHA to revert back to its previous systems.
Clemett noted AIMS was supposed to have cost $86 million and be implemented by March 1, 2021. Not only did the implementation fail, but the SHA has now spent $157 million on AIMS, and it is now projected to cost almost $240 million. The next implementation date has not been set, said Clemett.
“It will be imperative for the Authority to prepare and share with other government agencies a formal lessons learned report for AIMS once the IT project is complete, to help avoid IT system implementation failures on similar projects in government.”
Wait times for neurosurgery
Eight recommendations came from the provincial auditor on the issue of lengthening wait times for neurosurgery, one of four performance audits in the December 2023 report.
Clemett said the health ministry “has not improved mounting provincial waitlist for neurosurgery services. Overall the total waitlist for spine surgery in Regina has doubled since 2020, whereas Saskatoon has remained unchanged. Regina had 74 per cent of the total provincial waitlist of about 1000 spine cases at March 31, 2023. At April 2023, almost 240 patients have been waiting more than a year for neurosurgery.”
She noted that prolonged wait times to see a neurosurgeon increases the risk a patient’s health condition will worsen or become irreversible.
The auditor recommended the health ministry analyze the appropriate number of staff and physicians needed to meet neurosurgical service expectations and establish action plans to address workforce gaps. She also recommended communicating performance expectations to neurosurgery physicians and to monitor physicians against those expectations.
Clemett also recommended documenting clear surgery prioritization criteria to support consistent and fair access to neurosurgery services. She also recommended increasing the use of Saskatchewan Spine Pathway clinic referrals.
The auditor also recommended the ministry assess patient referral systems to help reduce wait times for first consultations with the neurosurgery physician, and to determine enhancements to surgical scheduling such as use of flex days, to ensure efficient use of operating rooms.
Little progress on oversight of special care homes
There was also a followup audit on the issue of private operators of special-care homes in Saskatoon. Clemett said Saskatchewan Health Authority made "little progress" on addressing recommendations made in 2017 when it came to overseeing contracted special care homes in the Saskatoon and the surrounding area.
“Special care homes continue to not meet service expectations related to the quality of care set by the Ministry of Health and the Authority,” said Clemett. “This is similar to our findings in 2017 and 2019—in fact, we found the results for special-care homes in the Saskatoon area worsened since 2019 for three performance measures.” She pointed to residents in daily physical restraints, the use of antipsychotics without a diagnosis, and newly occurring pressure ulcers.
She said the Saskatchewan Health Authority not taking timely actions to address special-care homes’ non-compliance “can negatively impact residents’ quality of life.”
Employee absenteeism at SHA
Another issue followed up by the provincial auditor was the growing amount of sick time taken by employees at the SHA.
Actual sick time reached 13.4 sick days for employees in 2022-23, however Clemett said the SHA neither monitor# actions taken by managers to work with the employees with excessive absenteeism, nor sufficiently analyzes and identifies strategies to address employee absenteeism in the Kindersley area of the province.
“We first made our audit recommendations in 2017, six years ago. Excessive employee absenteeism can negatively impact employee well-being, healthcare costs, and the quality of healthcare services delivered to the public.”
