The Ontario Wait Times Story: Improving Access and Improving Quality of Care

Size: px

Start display at page:

Download "The Ontario Wait Times Story: Improving Access and Improving Quality of Care"

Flora Ross
5 years ago
Views:

1 The Ontario Wait Times Story: Improving Access and Improving Quality of Care Jonathan C. Irish MD MSc FRCSC FACS Provincial Head, Surgical Oncology, Cancer Care Ontario Co-Chair, Surgical & Diagnostic Imaging Clinical Council 1

2 Where were we in 2004? No accepted definitions of wait times No standardized, accepted targets No knowledge of surgery activity No knowledge of wait lists No link to quality of surgery 2

The Ontario Wait Times Strategy In November 2004, Ontario

program - designed to reduce surgery and diagnostic imaging

five key priority areas: cancer surgery cardiac procedures

3 The Ontario Wait Times Strategy In November 2004, Ontario launched the Wait Time Strategy - establish a province-wide program - designed to reduce surgery and diagnostic imaging wait times - build the Wait Time Information System (WTIS) - five key priority areas: cancer surgery cardiac procedures cataract surgery hip and knee replacement surgery diagnostic imaging scans 3

4 Clinical Leadership and Engagement Provincial clinical leadership expert advisory panels developed to provide subject matter expertise and advice Performance targets developed: 1. Systematic review 2. Review of other jurisdictions 3. Development of consensus recommendations by the committee 4. Expert Panel Reports 4

5 Accountability Report of the Cancer Surgery Expert Panel Best Practice Targets and Approaches to Support Standardization Information to Monitor Performance and Support Quality Improvement Human Resources Funding The Organization of Services to Meet Quality Standards and Future Needs 5

6 Clinical Leadership and Engagement Provincial Clinical Leads provide continual guidance and feedback related to: - data - trends or changes - opportunities 6

The Power of WTIS Data Cancer Care Ontario developed the WTIS - accountable for data collection and reporting WTIS point-of-care data entry - capture data electronically through

7 The Power of WTIS Data Cancer Care Ontario developed the WTIS - accountable for data collection and reporting WTIS point-of-care data entry - capture data electronically through one system - integration into current OR booking systems saving time, increasing standardization and accuracy of data Supports active management of waitlists Near real-time data 7

8 The Power of WTIS Data Assists with management of wait times at the LHIN, hospital and surgeon level - Informs OR resource allocation decisions Provides a comprehensive picture of wait times to inform funding decisions 8

9 Where We Are Today 9

10 WTIS History of Achievements 2006/ / / / / / /13 Cardiac Cancer Hip/Knee Replacements Cataract MRI & CT Scans WTIS Phase I - III Total Cases 2006/07: ~ 1,300,000 Clinicians: ~1,700 Implementation: 81 WT funded hospitals Completed: June 2007 Ophthalmic Surgery Orthopaedic Surgery General Surgery Paediatric Surgery WTIS Expansion Adult Group 1 Cumulative Total Cases 2007/08: ~1,610,000 Cumulative Clinicians: ~2,600 Implementation: 82 WT funded hospitals Completed: March 2008 Paediatric (Pilot) Procedures: All Implementation: 1 Paediatric Pilot including London Health Sciences Centre and St. Joseph s Health Care (London) Completed: March 2008 Neurosurgery Vascular Surgery Thoracic Surgery Otolaryngic Surgery Gynaecologic Surgery Urologic Surgery Plastics/Reconstruction Oral & Maxillofacial Surgery & Dentistry Paediatric Surgery WTIS Expansion Adult Group 2 Cumulative Total Cases 2008/09: ~ 2,225,000 Cumulative Clinicians: ~3,350 Implementation: 86 WT funded hospitals Completed: March 2009 Reporting Category Updates WTIS Expansion 2009/10 Reporting Category Updates Service Detail Changes Completed: June 2009 WTIS Expansion 2009/10 Implementation: New hospitals & General Surgery Expansion, 94 WT funded hospitals Completed: August 2009 Wait 1, Surgery Wait 1 Collection Scope & requirements Completed: March 2011 MRI / CT New Data Elements WTIS Expansion 2011/12 WTIS Expansion 2011/12: Wait 1 System Build: Fall 2011 Completed: March 2012 MRI/CT New Data Elements Implementation: Winter 2012 WTIS Expansion 2012/13 WTIS Expansion 2012/13: ALC Implementation: Spring 2013 WTIS Maintenance Release (R-16) Implementation: Spring 2013 Paediatric (All Sites) Procedures: All Implementation: 86 WT funded hospitals Completed: March

Measuring and Reporting Access at Various Points The WTIS collects near-real time data for Surgery, Diagnostic Imaging and Alternate Level of

(Rehab, CCC, LTC, etc) Post-Acute Care (CCC, LTC, etc) Home Care Diagnostic Imaging Wait Time MRI/CT Wait 1: The time that the patient waits

It is measured from the time the referral is received to the date the first consultation with a clinician occurs less any patient-related

11 Measuring and Reporting Access at Various Points The WTIS collects near-real time data for Surgery, Diagnostic Imaging and Alternate Level of Care (ALC) Primary Care Provider Surgical Wait Time Wait 1 Wait 2 Specialist SETP OR ALC Wait Time Wait 3 Wait 4 Post-Acute Acute Care Care (Rehab, CCC, LTC, etc) Post-Acute Care (CCC, LTC, etc) Home Care Diagnostic Imaging Wait Time MRI/CT Wait 1: The time that the patient waits for a first consultation with a clinician. It is measured from the time the referral is received to the date the first consultation with a clinician occurs less any patient-related delays. Wait 2: The time that the patient waits for surgical or diagnostic imaging procedures. For surgical procedures, Wait 2 is measured from the Decision To Treat (DTT) date to the date the procedure is performed, less any patient-related delays. 11

12 Where We Are Today 12

13 Cancer Surgery Wait Time 2008 to Present January 2008 January 2009 January 2011 January

14 Transparent Reporting 14

15 Adult Surgery Wait Time Performance: January

Cancer Surgery Wait Time Trend From 2008+

16 Cancer Surgery Wait Time Trend From surgical oncology volumes have increased by 9% 16

17 The Mission Access to Care Access to Quality Care 17

18 Access to Quality Care 18

19 Surgeon Scorecard Pilot 19

20 How We Got Here: Key Enablers of the Wait Time Strategy Government commitment and leadership $$ Drivers Clinical leadership and advisors Public agency to manage collection and reporting Using a single provincial wait time information system Setting evidenced-based targets Demonstrating accountability to the public 20

21 Access to Care 21

Report on Provincial Wait Time Strategy

Hôpital régional de Sudbury Regional Hospital Report on Provincial Wait Time Strategy May 2007 Provincial Wait-time Strategy Announced by Minister of Health in November 2004 Focus is to increase access