Surgery wait lists reduced to zero at Montreal Children’s Hospital

No young patients are waiting more than nine months for surgery at the Montreal Children’s Hospital, following a reorganization of resources that took several years to complete.

The list of patients waiting for surgery for 12 months or more was the first to be reduced to zero this summer, and the same goal was achieved on Oct. 31 with the list of patients who had been waiting for nine months.

“It’s a moral issue ... to make children wait more than a year for surgical care,” said Dr. Sam Daniel, Chief of Surgery at the Children’s. “It’s something that’s difficult for us as a team.

“So the idea was to really organize the system, then improve access and equip ourselves to eliminate children waiting more than a year for surgery. It was a collective effort that started with a vision.”

The lists in question refer to patients who are “available” for surgery, according to a press release, meaning those who are ready to undergo surgery. They do not include patients who require treatment prior to surgery or those who are waiting because they need to take time off work.

A multidisciplinary committee was set up to analyze the situation. However, at the heart of this achievement — which is rare in the Quebec health-care system — is the work of data analysts who have been busy trying to understand how to organize the surgery schedule to reduce the waiting list, using mathematical models to determine how many days of surgery each doctor needed based on the number of patients waiting.

“The analysis gave us a calculation of the number of rooms each (surgical) division needed based on its waiting list,” explained Sonia Guilbeault, acting head nurse of the operating rooms at the Montreal Children’s Hospital. “So we had to review the surgical schedule, giving more time to the divisions that needed it and taking it away from those that had too much in relation to their waiting list. It was a big communication challenge.”

A partnership was also established with the AGM Anesthesia Clinic, a specialized medical centre that was able to take on some of the simpler surgeries that did not require hospitalization.

But as important as it was, mathematical modeling was only the beginning, Dr. Daniel pointed out: “We still had to be able to adequately prepare the children before their surgery and support them afterward, ensure that the necessary surgical equipment was available, and make sure that the surgeons were free to take advantage of the time they now had.

“We had to establish safety guidelines,” he emphasized. “When we suddenly started doing things differently, we had to review all our care protocols to determine what to do if something happened.”

And that’s not to mention what Dr. Daniel calls “blind spots,” such as patients who have been waiting for a year or more but whose cases are not considered urgent.

“Yes, but urgent for whom?” he asks, or employees who had to redouble their efforts to balance work and family life for the project to succeed.

Ultimately, said Sonia Guilbeault, “everyone got on board because everyone thought it was important.”

As the waiting lists decreased, she added, the teams “immersed themselves in the project” and put their shoulders to the wheel to achieve the objectives.

“We have a system that is good and caring,” concluded Dr. Daniel. “We just need to nurture it with kindness so that it continues to function.”

This report by The Canadian Press was first published in French on Nov. 6, 2025.

By Jean-Benoit Legault, The Canadian Press