Planning for cardiac surgical services: Advice from an Ontario consensus panel

The cardiac Care Network of Ontario (CCN) Consensus Panel on Cardiac Surgic al Services drew on the literature and its own expertise to recommend guide lines for expanding services. This report, which is not an official positio n paper of the Canadian Cardiovascular Society, presents these recommendati ons. Rates of surgery are linked to diagnostic capacity, requiring increase s in interventional therapies to match increases in invasive diagnostic act ivity. For quality and efficiency, panel members recommend an annual minimu m of 150 procedures per surgeon and 500 per centre; a centre should serve a minimum population of 500,000. Services should be as close to patients' ho mes as possible while maintaining recommended volumes. Expanding the CCN's cardiac surgery database to include other cardiac modalities will yield a m ore accurate assessment of waiting times. The panel recommends collaborativ e regional planning associations, mentorship arrangements between new and e xisting centres, prompt action on human resource shortages and exploration of alternative funding models.