Elective surgery waiting list episode—patient listing status, readiness for surgery code N

Identifying and definitional attributes

• Health, Superseded 18/12/2019

Value domain attributes

Representational attributes

Collection and usage attributes

CODE 1   Ready for surgery

Patients who are prepared to be admitted to hospital or to begin the process leading directly to admission for surgery.

The process leading to surgery could include investigations/procedures done on an outpatient basis, such as autologous blood collection, pre-operative diagnostic imaging or blood tests.

CODE 2   Not ready for surgery – staged patients

Patients who have undergone a procedure or other treatment and are waiting for follow-up elective surgery, where the patient is not in a position to be admitted to hospital or to begin the process leading directly to admission for surgery, because the patient’s clinical condition means that the surgery is not indicated until some future, planned period of time.

Examples include a patient who has had internal fixation of a fracture who will require removal of the fixation device after 3 months, a patient who requires a ‘check’ cystoscopy to check for cancer 12 months after surgery to remove a tumour in the bladder, and a patient requiring rectal cancer surgery 6-8 weeks after neoadjuvant chemoradiotherapy for colorectal cancer.

CODE 3   Not ready for surgery – pending improvement of clinical condition

Patients for whom surgery is indicated, but not until their clinical condition is improved, for example, as a result of a clinical intervention.

Examples include patients who require a cardiac work-up before a total hip replacement and patients with respiratory insufficiency who require physiotherapy to maximise respiratory function before a hernia repair.

For such patients, a decision has already been made that surgery should take place. Patients should not be regarded as ‘not ready for surgery—pending improvement of their clinical condition’ when they are undergoing routine monitoring or investigations before a decision is made as to whether surgery is required.

CODE 4   Not ready for surgery – deferred for personal reasons

Patients who for personal reasons are not yet prepared to be admitted to hospital. Examples include patients with work or other commitments that preclude their being admitted to hospital for a time.

Source and reference attributes

National Health Information Standards and Statistics Committee - Emergency Data Development Working Group; Hospitals Principal Committee - Project Steering Committee on National Definitions for Elective Surgery Urgency Categories

AIHW 2013. National definitions for elective surgery urgency categories: proposal for the Standing Council on Health. Cat. no. HSE 138. Canberra: AIHW. Viewed 30 July 2015,  http://www.aihw.gov.au/publication-detail/?id=60129543979

Data element attributes

Collection and usage attributes

Patients should only be added to waiting lists (that is, regarded as 'ready for surgery' for the purpose of monitoring waiting times, and for the purpose of allocation of a surgery date) when they are personally and clinically ready for surgery.

Patients deferred for personal reasons should not be added to the waiting lists until they are ready for surgery. They should be suspended from the waiting list if they defer after being ready for surgery.

Details of how and when patients move between 'ready for surgery' categories are not needed for national or local reporting of the data. Periods when patients are not ready for surgery should be excluded in determining Elective surgery waiting list episode—waiting time (at removal), total days N[NNN] and Elective surgery waiting list episode—waiting time (at a census date) total days N[NNN].

The dates when a patient listing status changes need to be recorded. A patient's classification may change if he or she is examined by a clinician during the waiting period, i.e. undergoes clinical review. The need for clinical review varies with the patient's condition and is therefore at the discretion of the treating clinician. The waiting list information system should be able to record dates when the classification is changed using the Elective care waiting list episode—category reassignment date, DDMMYYYY.

Source and reference attributes

National Health Information Standards and Statistics Committee

Relational attributes