Managing Wait Times
- February 2007
- Français
The database of wait times for targeted surgeries and tests in Ontario now stretches over more than one year, and statistics from the Niagara Health System (NHS) are showing considerable improvements in wait times for cancer surgeries, hip replacement surgeries and MRI and CT scans. On a visit to Niagara in January, Dr. Alan Hudson, the lead for Ontario's Wait Time Strategy, took time out to discuss the successes and challenges of the strategy, both provincially and within Niagara for five targeted areas; cancer surgery, cardiac procedures, cataract surgery, hip and knee replacements, and MRI and CT diagnostic exams.
"We have seen a substantial improvement in hip and knee surgery wait times in Ontario and are doing 50% more cases than just a few years ago," Dr. Hudson says. "We've done very well in such a short time, and in part that is due to the help and advice we've received from other countries." Although Ontario started its Wait Time Strategy later than in other countries, Dr. Hudson says none of them have had the same success as Ontario in such a short period of time.
Thanks to increased funding to hospitals over the last two years – $614 million to Ontario hospitals which includes $6.3 million to the NHS – the volume of patients receiving surgeries and diagnostic tests has increased, and in most areas, wait times have decreased. The data on the Ontario Wait Times website tracks the time it takes from when the physician specialist determines a patient needs surgery or a CT/MRI test to when the test or surgical procedure is actually carried out. In Niagara, NHS patients waited 190 days for hip replacement surgery, compared to an average of 278 days in Ontario. The Ministry of Health and Long-Term Care's target wait time for hip surgery is 182 days.
In total, the NHS has performed an additional 2,233 surgical procedures with the funding, (328 hips/knees; 1,735 cataracts; and 170 cancer surgeries); 4,763 diagnostic hours (1,071 CT hours and 3,692 MRI hours) and 1,050 chemotherapy visits.
Not only is the Wait Time Strategy of benefit to patients through improved access to care and improved health, but the data generated by the project is changing the health-care system from the inside. NHS Chief of Staff Dr. Bill Shragge says our hospital system is becoming more efficient because the strategy comes with coaching and hands-on hospital visits so health-care professionals can learn what's working well at another hospital and improve to deliver best practice care. "We've had a coaching visit to our surgical program and it has already had an enormous impact," Dr. Shragge says.
Another important change is the availability of data, which was simply not generated in a timely fashion before the Wait Time Strategy. "From the perspective of planning, the data we are now capturing and seeing from other hospitals allows us to launch new initiatives and to better examine our resources in people, money, space and time," he says. "We are starting to experience a sea-change in our culture, and the data is evidence that is driving that change."
Internal collaboration has improved within the NHS, as have regional relationships within the Local Health Integration Network (LHIN) of Hamilton, Niagara, Haldimand and Brant. "It brings into sharper focus the regional perspective in our LHIN 4, and one result is an exciting initiative now underway to better co-ordinate the intake and management of patients requiring hip and other joint replacement surgeries. This best practice model will be rolled out at all the hospitals in our LHIN because we are getting better at sharing our learning."
The benefits to patients are many, Dr. Shragge says, and ultimately the Wait Time Strategy is about providing quality care that incorporates six key elements; care that's effective, efficient, equitable, safe, humane and timely. "This is a robust program that is having a multi-dimensional impact on more than the five targeted areas of cancer surgery, cardiac procedures, cataract surgery, hip and knee replacements, and MRI and CT diagnostic exams," Dr. Shragge says. "It is improving access to care for a wide range of our patients and changing the way we deliver that care."
More information is available on the Wait Time Strategy website at www.ontariowaittimes.com.