The Lucas Algorithm is a standardized tool that supports collaborative surgical and endoscopy waitlist management by prioritizing patients based on specialist-assigned priority level, clinical acuity, and target wait times.
Patients are assigned an NSCATS code or one of the six PARNS priority levels for surgery, or an NSCATs-E code for endoscopy, and the algorithm sorts them accordingly to ensure high-priority patients are booked promptly, long-waiting patients are not overlooked, and care is delivered fairly and consistently. Used across sites, zones, and provincially, it helps ensure patients receive the right care at the right time.
Supported by Nova Scotia Coding Access Targets for Surgery (NSCATS) or Endoscopy (NSCATs-E)
NSCATS/NSCATs-E links directly to the Lucas Algorithm, which prioritizes patients for booking based on surgeon assigned NSCATS code or a PAR-NS priority level for surgical procedures where no NSCATS code currently exists. For Endoscopy this would be an endoscopist assigned NSCATs-E code or one of the endoscopy override codes available. This supports consistent, equitable access to surgery and endoscopy across the province.
- NSCATS/NSCATs-E includes clinical modifiers for many procedures, allowing you to assign the most appropriate wait time based on patient condition—not just procedure type.
- This is especially critical for those whose practice includes cancer surgery, among other procedures. Non-cancer procedures that do not have a clinical acuity equal to cancer should be prioritized as such, so they do not appear in the queue for surgical booking alongside cancer cases. Only those non-cancer cases that require a short wait time equal to cancer should be prioritized with those procedures’ shortest wait time.
- As a surgeon/endoscopist, you retain clinical autonomy to override NSCATS/NSCATs-E where clinically determined.
- Please note that assigning shorter wait times than clinically necessary will move patients inappropriately higher in the queue. Over time, this can lead to:
- Greater reliance on manual overrides, reducing confidence in the booking system.
- Increased numbers of overdue patients (purple/black) on your waitlist.
- Potential delays for patients with higher clinical need.
- Please note that assigning shorter wait times than clinically necessary will move patients inappropriately higher in the queue. Over time, this can lead to:
New Metric for Waitlist Management
A new indicator added to the waitlist management tool tracks alignment with the Lucas Algorithm.
It identifies site-level compliance with the Algorithm, ensuring that patients' wait time and priority level are considered when determining who is booked for surgery or endoscopy.
By introducing this indicator, zones and sites will be better equipped to identify opportunities for improvement, support more consistent waitlist management, and ultimately help patients receive the care they need, sooner.
The Name Behind the Algorithm: The Work of Lucas Parafianowicz
