Objectives: Wait times in Canada are increasingly being monitoredas an indicator of quality health care delivery. We created a higherresolution picture of the wait experienced by urological surgerypatients beginning with the initial referral. In doing so, we hopedto (a) identify potential bottlenecks and common delays at ourcentre, and (b) identify predictors of wait time.Methods: The charts of 322 patients undergoing surgery fromNovember 2007 to March 2008 were reviewed and specific dates,patient factors and delays were recorded. The data were used todetail the patient’s wait and to determine the patient factors whichwere predictive of wait time.Results: The mean time from decision to operate to the day ofoperation was 75.87 days for all patients. This number accountsfor 53% of the wait time, while the time from referral to decision tooperate is 47%. Predictors of a decreased wait time include cancercases, younger age, urgency score, repeat patients and female genderin multivariate analysis. Delays were experienced by 16.8% ofpatients; most common delays were operating room cancellations/time constraints, patients requiring further optimization and delaysin referral (4.7%, 3.4% and 3.1%, respectively).Conclusions: The waiting process is complex; the actual waitingtime that a patient must endure is much longer than the wait timestraditionally recorded and reported by hospitals. As strategies areimplemented to decrease wait times, it will become increasinglyimportant to monitor the entire wait time from referral to operationand to ensure that changes are being made that truly decreasewait times and not simply shift where and when the patient waits.