This article written in french by Corinne Prince was automatically translated using AI
From Sunday, June 29, to Saturday, July 26, no patient had been waiting for surgery for more than a year at the Centre intégré de santé et de services sociaux (CISSS) de Laval.
Since the beginning of 2025, that figure has fluctuated between 1 and 0, positioning Laval as one of the top-performing regions in Quebec when it comes to surgery.
During the above-mentioned period—the most recent data released by the Ministry of Health and Social Services (MSSS)—only Laval, Côte-Nord, and Nord-du-Québec had no patients waiting longer than a year.
By comparison, 1,752 patients had been waiting more than a year in the Montreal region, the highest number in the province, followed by 569 in Lanaudière and 352 in the Laurentians.
“[Having no] wait times of more than a year—here in Laval, unions are pleased about that,” said Déreck Cyr, president of the Syndicat des infirmières, inhalothérapeutes et infirmières auxiliaires de Laval (SIIIAL-CSQ). “But should we be satisfied with a one-year wait? Is that timeframe reasonable? We know that’s the ministerial target, but shouldn’t we aim lower? […] In general, the lower the targets, the better. Some people are still waiting a long time.”
Satisfied with its performance, the CISSS de Laval partly attributes its success to an innovative tool designed to improve access to surgeries.
Equality versus Equity
The CISSS de Laval has been using a custom-built Excel tool for about 10 years to improve fairness in the distribution of surgical priorities.
“[Before,] we would take our operating rooms and divide them equally, according to the number of surgeries, among all specialties. Then, the head of medical services would distribute them equally among each of their members,” explained Frédéric Pageot, senior advisor for access and clinical performance at the CISSS de Laval and creator of the tool.
Equality and equity are not the same thing. In other words, even though the traditional way of allocating surgical time ensured equal numbers for all doctors, patient access to care was not distributed fairly.
“When you distribute equally, you inevitably end up with inequitable waiting lists,” said the Excel tool’s administrator. “[For example], we might have two patients with the same medical condition, the same age, and the same surgery: if one fell under Dr. X, they could be operated on within three months; if under Dr. Y, they could wait a year and a half!”
The Tool
The Excel tool analyzes the waiting lists of all Laval surgeons in order to prioritize time slot allocation based on multiple parameters, including waiting list fluctuations, procedure urgency, required operating time, and the distribution of technical resources.
Recently, two new elements were introduced: a minimum threshold and flexibility granted to heads of medical services, who are best placed to consider the specific needs of their teams.
The first ensures that a physician always has a minimum number of operations within a given period in order to maintain their skills and be able to handle urgent cases when needed.
Three times a year, a working committee updates the waiting lists and analyzes the “robust and reliable” data provided by the Excel tool to plan the upcoming period more objectively.
In addition to improving access to services for patients, the tool also benefits surgeons, who can now better balance their time between the operating room and the clinic—a very useful practice for managing their patient lists.
“They don’t lose anything, and we end up with more balanced lists,” said Frédéric Pageot, proud of this practice, which is quite unique in Quebec, and of the convincing results it has brought to the CISSS de Laval.
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