Measuring what matters: How data analytics supports improvements in surgical wait times and access to care

Nova Scotia Health’s efforts to reduce surgical wait times extend beyond operating rooms and often begin with data. For Sean Smith, data tells a story that shapes how improvements can be made to reduce wait times, reduce wait lists, and create equitable access to care for Nova Scotians.

“My role is to provide data analysis that helps reveal our strengths and opportunities, solve problems and support decision making,” says Sean, analytics lead for Perioperative (Surgical) Services. “My goal is to explain the story buried within data and help translate that story into projects that improve surgical access and outcomes.”

A primary focus for Sean is understanding where patients experience delays, why they happen, and how to address them in a fair and sustainable way.

A key tool in this analysis is the Patient Access Registry – Nova Scotia, or PAR-NS, the province’s surgical waitlist management database. It contains information on wait list size, wait times, and operating room use that can support decision making and provide a comprehensive view of how the health system is performing. 

“Surgical wait lists and wait times are not the same across the province,” says Sean. “PAR-NS helps us understand differences in wait times between hospitals, surgeons and sub-specialties, and track how improvement strategies are impacting wait times over time.”

This informs decisions at every level – from who gets booked next for surgery to where resources could be increased or used differently to improve care. 

The growing reliance on data to guide decisions is something Sean views as a positive trend for Nova Scotia Health and our patients.

“We were able to clearly demonstrate that surgical wait times were influenced by where patients live. That evidence helped support the implementation of a provincial centralized intake system and eReferral (electronic referral) model designed to balance access to care more equitably and allow patients flexibility to travel for faster care, if they are able.”

The centralized booking model is another system change that helps specialist offices and surgery sites better co-ordinate scheduling so those patients who need care most urgently, and those who have been waiting the longest, receive care first.

Collaboration plays a vital role in turning analysis into action. Sean works closely with clinical leaders, operational teams, and fellow analysts. “The surgical services leadership team is very data-driven, which makes my role a natural fit. I’ve been fortunate to establish strong working relationships with these leaders and to better understand the goals they are aiming to achieve. These relationships are critical to offering the best possible insights I can.”

One key performance indicator that Sean makes available to teams is the number of patients waiting more than one year after a decision is made to operate. These patients are known as long-waiters and seeing the percentage of long waiters on wait lists drop is a clear sign that efforts are paying off.

"Several strategies have been implemented to improve access, and we have recently achieved a 10-year low in patients on our surgical wait list, and those waiting more than one year,” he says. “It’s rewarding to support an initiative like this, especially when these successes can be quantified and the patient impact can be seen.”

After 20 years as an analyst, Sean remains motivated by both progress and purpose, where success means more than shorter wait lists. 

“Reduced wait times and reduced wait lists across Nova Scotia, regardless of geography, signal that we are moving in the right direction,” he says. “Behind every data point is a person waiting for care. That’s what keeps us focused on continuing to improve.”

Nova Scotia Health data highlights:

• Year-end surgical waitlist, as of Dec. 31, 2025, was at a 10-year low (compared to past 10 Decembers), despite a provincial population increase of 154,000 during that 10-year period.
• In the Canadian Institute for Health Information’s 2025 wait times report for priority procedures, Nova Scotia was the only province to rank in the top three for the percent of patients having surgery within national benchmarks for hip replacements, knee replacements, and cataract surgeries. Nova Scotia had never previously achieved this distinction and was the only province, other than British Columbia, to do so in the past five years.
• Nova Scotia Health completed 14,800 more surgical hours in calendar 2025 than 2019. This increase is more than Northern Zone’s entire surgical output in 2019 (14,200 surgical hours).
• Surgical long waiters (waiting more than 365 days) decreased by 1,600 (2023-24 vs. 2024-25).

Photo of Sean Smith at his office in Eastern Kings Memorial Health Centre.