June 27, 2012
The Wait Time Alliance (WTA) has issued national report cards annually since 2007. Initially, our report cards were solely directed at provincial performance in the five areas identified in the 2004 Health Accord: cancer (radiation therapy); heart (bypass surgery); joint replacement (hip and knee); sight restoration (cataract) and diagnostic imaging (CT and MRI). Since then, the WTA has directed its attention
toward: (1) broadening the scope to include Canadians’ access to all areas of care; (2) improving the quality of public reporting on timely access; (3) highlighting issues that contribute to lengthy wait times; and, (4) identifying best practices to improve wait times.
The 2012 report card is the WTA’s most comprehensive effort to date to shed light on all of these areas.It contains six sections:
Posted in READ Portal, Reports & Papers | Tagged with Access to care, Benchmarking, Canada, Indicators, Wait lists | No Comments
June 11, 2012
Background:
Wait time targets are controversial since some claim that the push for improved efficiency could compromise patient safety. On the other hand, spending long hours waiting for care in an ED has itself been shown to have safety risks. We tested the question of whether ED patients, who arrived during a shift when a greater percentage of all ED patients seen on that shift met their respective MOHLTC ED LOS targets, had a lower risk of mortality or hospital admission in the 7 days following ED discharge. We looked only at outcomes among patients discharged from the ED, since subsequent outcomes among admitted patients could be due to in-patient, as opposed to ED, care.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Hospitals, Wait lists | No Comments
January 12, 2012
“This edition of Waiting Your Turn indicates that waiting times for elective medical treatment have increased since last year. Specialist physicians surveyed across 12 specialties and 10 Canadian provinces report a total waiting time of 19.0 weeks between referral from a general practitioner and receipt of elective treatment. At 104 percent longer than it was in 1993, this is the longest total wait time recorded since the Fraser Institute began measuring wait times in Canada.
Wait times between 2010 and 2011 increased in both the segment between referral by a general practitioner to consultation with a specialist (rising to 9.5 weeks from 8.9 weeks in 2010), and the segment between a consultation with a specialist and receipt of treatment (rising to 9.5 weeks from 9.3 weeks in 2010). In fact, physicians themselves believe that Canadians wait nearly 3 weeks longer than what they consider is clinically “reasonable” for elective treatment after an appointment with a specialist. There is, however, a great deal of variation in the total waiting time faced by patients across the provinces. While Ontario reports the shortest total wait in 2011 (14.3 weeks); Prince Edward Island reports the longest at 43.9 weeks. The same is true of variations among specialties. Patients wait longest between a GP referral and plastic surgery (41.6 weeks), while those waiting for medical oncology begin treatment in 4.2 weeks.
It is estimated that, across all 10 provinces, in 2011 people are waiting for an estimated 941,321 procedures. This means that, assuming that each person waits for only one procedure, 2.8 percent of Canadians are waiting for treatment. Importantly, physicians report that only about 9.4 percent of their patients are on a waiting list because they requested a delay or postponement. The results of this year’s survey indicate that despite high levels of health expenditure and provincial wait time strategies, it is clear that patients in Canada are waiting too long to receive treatment.”
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November 16, 2011
“Objective: To determine whether patients who are not admitted to hospital after attending an emergency department during shifts with long waiting times are at risk for adverse events.
Conclusions: Presenting to an emergency department during shifts with longer waiting times, reflected in longer mean length of stay, is associated with a greater risk in the short term of death and admission to hospital in patients who are well enough to leave the department. Patients who leave without being seen are not at higher risk of short term adverse events.”
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Posted in Journal Articles, READ Portal | Tagged with Mortality rates, Risk assessment, Statistics & numerical data, Wait lists | No Comments
August 9, 2011
“Hospitals are tackling a dangerous and costly side effect of emergency-room overcrowding and long wait times: the growing number of patients who get fed up and leave without treatment.
To speed patients through the system, emergency rooms are adopting so-called lean-management principles pioneered by such companies as Toyota Motor Corp. to increase efficiency, cut costs and provide better service.
That means streamlining the traditional methods of triage and reserving beds for only the sickest patients, abandoning the longstanding rule that every patient gets a bed. It also means staffing the ER with less-costly providers such as nurse practitioners and physician’s assistants, so more expensive ER doctors can focus on care and not on paperwork, test ordering and discharge plans.”
Posted in Mass Media Articles, READ Portal | Tagged with Emergency service, Patient-centered care, Process improvement, Wait lists | No Comments
July 27, 2011
“It is now time to discuss the renewal of the 2004 Health Accord that is due to expire in 2014. The 2004 Accord devoted considerable attention to improving access to timely care for Canadians. It promised significant reductions in wait times and provided $41 billion in ongoing funding…
The WTA report card contains five sections:
- Grading the original five “priority areas” to government benchmarks, including a five-year assessment;
- Grading beyond the five “priority areas” using WTA benchmarks;
- Grading provincial wait-time websites;
- The impact of alternate levels of care (ALC) stays on wait times;
- Highlighting WTA members’ ongoing work to mitigate, measure, monitor, and manage wait times.”
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with Canada, Wait lists | No Comments
June 27, 2011
“An interactive tool was developed for the ophthalmology department of the Academic Medical Center to quantitatively support management with strategic patient-mix decisions. The tool enables management to alter the number of patients in various patient groups and to see the consequences in terms of key performance indicators. In our case study, we focused on the bottleneck: the operating room. First, we performed a literature review to identify all factors that influence an operating room’s utilization rate. Next, we decided which factors were relevant to our study. For these relevant factors, two quantitative methods were applied to quantify the impact of an individual factor: regression analysis and computer simulation. Finally, the average duration of an operation, the number of cancellations due to overrun of previous surgeries, and the waiting time target for elective patients all turned out to have significant impact. Accordingly, for the case study, the interactive tool was shown to offer management quantitative decision support to act proactively to expected alterations in patient-mix. Hence, management can anticipate the future situation, and either alter the expected patient-mix or expand capacity to ensure that the key performance indicators will be met in the future.”
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Operating rooms, Wait lists | No Comments
June 22, 2011
According to a new report by the Wait Times Alliance, patients waiting for different levels of care are one of the main reason for long waits in hospitals. Patients that could receive better care elsewhere are put into hospital care while waiting to receive treatment. Typically these are elderly patients with chronic conditions who enter the hospital by way of the emergency departments and stay for an average of 26 days. It is estimated that for every hour they remain at the hospital, four people are denied emergency department access
There are a number of suggestions for dealing with this issue, including investing more into home care and providing support to home health care workers. However it is achieved, the goal is to ensure that patients receive care in the most appropriate setting.
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October 13, 2010
“Long access times1 are a major problem in hospitals around the world. Not only patients requiring urgent attention want to be seen as soon as possible, also patients with an appointment expect to be seen at a short notice. If we can develop cost-effective solutions to reduce access times, budgets do not have to be increased. Such solutions would increase efficiency in the use of available resources rather than requiring investment in additional equipment and staff.
To reduce the access times of an endoscopy department, we developed an iterative combination of Discrete Event simulation and Integer Linear Programming. We developed the method in the Endoscopy Department of the Academic Medical Center in Amsterdam and compared different scenarios to reduce the access times for the department. The results show that by a more effective allocation of the current capacity, all procedure types will meet their corresponding performance targets in contrast to the current situation. This improvement can be accomplished without requiring additional equipment and staff. Currently, our recommendations are implemented.”
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