ORIGINAL ARTICLE Patient attitudes toward pooled surgical waitlists in urogynecology Rebekah A. Zee 1 & Aisling A. Clancy 1 & Hisham Khalil 1 Received: 25 April 2019 /Accepted: 10 July 2019 # The International Urogynecological Association 2019 Abstract Introduction and hypothesis Pooled surgical waitlists are used to maximize the use of surgical resources; however, patients’ views of this strategy are poorly understood. We sought to evaluate patients’ attitudes toward a pooled waitlist for urogynecology and pelvic reconstructive surgical procedures. Methods Patient and provider focus groups were used to inform the design of a survey that was distributed to patients at the time of consent for female pelvic reconstructive surgical procedures. All responses were collected anonymously. Patient attitudes toward surgical wait times and the potential for a pooled surgical waitlist were explored. Grouped responses by age, procedure type, and perceived disease severity were examined. Results One hundred seventy-six patients were surveyed. Thirty-four percent were amenable to the option of a pooled surgical waitlist; 86% agreed or strongly agreed that they preferred to have their surgery performed by their own care provider. Only 18% would agree to be on a pooled surgical waitlist if it shortened their wait time. Older women (≥ 65 years) were more likely to disagree or strongly disagree that they “would like the option of having surgery done by the next available skilled surgeon” (56.2% vs. 72.0%, p = 0.028). Self-perceived severe disease and mid-urethral sling surgery were not associated with a higher acceptance of pooled surgical waitlists. Conclusions Acceptance of pooled surgical waitlists among urogynecology patients was overall low, irrespective of disease severity. Improving our understanding of urogynecology patients’ concerns and potentially negative perceptions of surgical waitlists is needed to ensure patient comfort and satisfaction are not compromised if this strategy is adopted. Keywords Health services administration . Waiting lists . Pelvic organ prolapse . Urinary incontinence Introduction More than one in ten women will undergo pelvic floor recon- structive surgery for management of pelvic organ prolapse or urinary stress incontinence in their lifetime [1]. Waitlists for these procedures, particularly in publicly funded healthcare systems, can span months despite the considerable impact pelvic floor disorders can have on patients’ quality of life. Given the growing demographic of seniors [2], an even great- er demand for pelvic reconstructive surgery is anticipated in the coming years [3]. Identifying effective strategies to reduce surgical wait times is therefore a high priority [4]. One proposed strategy to reduce surgical wait times is to ‘pool’ surgical waitlists. Systems in which patients remain under the care of the surgeon who first assessed and consented them for a given procedure can result in large differences in wait times for the same procedure as waitlists can vary be- tween assigned providers. In systems with pooled surgical waitlists—such as those used at many centers in Canada, the UK, and Australia—the patient is assigned to the next avail- able surgical time, even if it is not with the consultant by whom they were initially assessed. In principle, this approach more evenly distributes the workload as patients flow to sur- geons who are not at full capacity [5]. It may also optimize the use of operating room time as shorter procedures could be added or used to replace canceled cases, and it could simplify Rebekah A. Zee and Aisling A. Clancy contributed equally to this work. Conference presentations Pilot study was presented at the SOGC 74th Annual Clinical & Scientific Conference in Victoria, BC, Canada, on June 28, 2018. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-019-04050-4) contains supplementary material, which is available to authorized users. * Hisham Khalil hkhalil@toh.ca 1 Division of Urogynecology, Department of Obstetrics and Gynecology, The Ottawa Hospital, 1967 Riverside Dr, Ottawa, ON K1H 1A2, Canada International Urogynecology Journal https://doi.org/10.1007/s00192-019-04050-4