Canadian Wait Times Project Watching & Waiting: A Status Report

1. Canadian Wait Times ProjectWatching & Waiting: A Status Report Association of Canadian Academic Healthcare Organizations Fall Invitational Conference November 4, 2005 Ottawa, Ontario Dr. Brian Postl Federal Wait Times Advisor

2. Purpose • Review the FMM Accord and Mandate • Review progress as Federal Wait Times Advisor • To solicit comments and input into the initial proposals regarding efforts required to address waiting times in our health care systems

3. September 2004 FMM Accord: 10 year Plan to Strengthen Health Care • First Ministers committed to : • achieve meaningful reductions in wait times beginning with priority areas such as cancer, heart, diagnostic imaging, joint replacement and sight restoration by March 31, 2007 • establish multi-year targets by December 31, 2007 • establish comparable indicators of access to services by December 31, 2005. • establish evidence based benchmarks for medically acceptable wit times in 5 areas by December 31, 2005 • Wait Time Reduction Fund established - $5.5 Billion (of the $41 Billion) over 10 years to achieve wait time reductions and augment provincial and territorial initiatives

4. What Canadians are saying…. • Canadians’ perception of and experience with waiting times • System accountability

5. What has been done so far • Meetings with: • provincial officials to learn about progress within provincial jurisdictions and barriers to success • key collaborators - CIHI, CIHR and physician organizations • national stakeholder organizations • Preliminary proposals regarding wait time management

6. What needs to be done about….Indicators and Benchmarks • Sort out definitions • Satisfy the FMM 2004 Accord by developing comparable indicators and benchmarks to the extent that the evidence permits by December 31, 2005 • Develop a research process through CIHR to drive the continued development of evidence-based benchmarks • Determine a trigger mechanism for declaration of benchmarks • Explore potential for provincial access targets

7. What needs to be done about…The Health Care System System transformation in these four areas: • Management and Innovation • Information Technology • Physician Roles and Responsibility • Public Education

8. What needs to be done about….Management and Innovation • Refocus the care system on patients • Build wait time management processes using wait time coordinators, navigators, managers • Train them and give them tools for prioritizing patients and listing them on wait registries • CHSRF Extra-like program • Develop a service approach by considering options such as: • Single/common wait lists and using a first available slot approach • optimizing the use of “queuing theories” • case management strategies

9. What needs to be done about…Information Technology • Integrate IT across health care systems • Registry development • Potential to link to EHR development • Task Canada Health Infoway to begin this process

10. What needs to be done about…Physician Roles and Responsibilities • Recognize the efforts to date of the medical community • Re-establish physician responsibility for timely access to care and the care of patients on wait lists

11. Physician Roles and Responsibilities (cont.) • Move to a clinical service-based culture • Rebalance influences on professional behavior • Emphasize ‘appropriateness’ • Re-engage professional bodies • CMA/WTA • Specialty Societies • Deans of Medicine • Royal College of Physicians & Surgeons • Canadian College of Family Physicians • Provincial Colleges of Physicians & Surgeons

12. What needs to be done about….Public Education • Address misconceptions and confusion • Communicate system solutions • Create new communication tools or refine existing ones • Showcase successes • Communicate our short term and longer-term plans

13. What needs to be done about…Additional Issues • Prevention • Care of children • Surge capacity • Health human resources • “Cinderella” diseases • Gender-based analysis • Provincial priority list

14. Moving Forward….A Summary • In the short term - benchmarks & indicators • In the longer term – system transformation