In order to improve wait times in Canada with the next decade, the Wait Time Alliance recommends the following:
Implement a charter on rights and responsibilities
Canadian governments should implement a charter on rights and responsibilities that would include targets and enforceable maximum wait-time guarantees for patients to access timely care. Such charters exist in England and Scotland, while other countries, such as Finland and Denmark, have enforceable patient wait-time guarantees. This charter would apply to patients, providers, funders and organizers of care. It would require robust supporting mechanisms such as funding and human resources to ensure accountability and track performance. Alberta is the first province to take steps toward implementing a health charter.
Address the Alternate Level of Care issue
The federal and provincial/territorial governments should collaborate with stakeholders in developing a pan-Canadian seniors strategy to address the issues of:
- Increased numbers of Alternate Level of Care patients, many of whom have dementia and other chronic conditions
- The lack of appropriate residential and community-based options for seniors
The most important action to improve access to timely specialty care for Canadians is to address the Alternate Level of Care issue supported in part by a national dementia plan. The strategy should also consider how to integrate more flexible residential options that better meet the needs of seniors.
Implement strategies to make better use of surgical infrastructure
Governments, regional health authorities and hospital administrators along with health care providers should implement strategies to make better use of surgical infrastructure (both physical and health human resources), such as making better use of untapped health infrastructure in community hospitals and rural areas. A frequent contributing factor to wait times is not so much the lack of operating room infrastructure but how the existing infrastructure is used. Much of specialty medical care depends on institutional health care facilities such as hospitals and their resources, including operating rooms and hospitals beds. To control costs, resources such as operating room time are frequently cut.
Establish a partnership of provincial wait-time officials, CIHI, national specialty societies and patients
A partnership should be established among provincial wait-time officials, CIHI, national specialty societies and patients to:
- Identify a common vision for the purpose, use and benefits of wait-time data collection.
- Oversee efforts to improve the quality and uptake of wait-time data for a full range of care.
- Identify how data collection efforts can be properly supported.
The WTA has started working with these groups and we have appreciated their willingness to collaborate further on strategies to reduce wait times.
The federal government should be an active partner in improving timely access
The federal government should be an active partner in working with provinces and territories and other stakeholders to improve timely access, given that ensuring all Canadians have timely access to necessary medical care is a pan-Canadian issue and given the high economic cost of waiting to families and governments. There are currently significant gaps in timely access to a wide range of care across the country. A national approach to providing timely access to care is something found in other countries with high-performing universal health care systems.
To ensure all Canadians have timely access to medically necessary care, the WTA urges the federal government to continue to support efforts to provide timely care to Canadians through three primary roles.
- In collaboration with system stakeholders, develop a pan-Canadian seniors’ strategy and a national dementia strategy.
- Provide ongoing funding for the Canadian Institute for Health Information to continue its work to:
- standardize wait-time data across Canada for all portions of the total wait experienced by the patient; and
- develop pan-Canadian health system performance measures featuring timely access indicators across the continuum of care that would be applied to all Canadians including those patients who are the responsibility of the federal government.
- Provide ongoing support for a pan-Canadian approach to health human resource planning to ensure adequate resources in support of a sustainable health care system across the country.
- Establish a second phase of the National Wait Time Initiative that would build on the wait-time work and knowledge achieved over the past decade to support a higher level of system performance.
- Continue funding the Canadian Institutes for Health Research and the Canadian Foundation for Healthcare Improvement to support research and implementation strategies related to wait-times reduction and management.
- Provide funding support for projects/initiatives that contribute to the dissemination of Canadian and international leading practices in wait-time reduction and management strategies.
- Establish a health infrastructure fund to promote better use of existing surgical infrastructure across the country (both physical and health human resources) and the adoption of community-based infrastructure to address the increased demand for care provided outside of acute care facilities.