My husband waited one year to see a surgeon and two years for the hip replacement. The pain he went through while waiting for surgery is unbelievable. – Francise, Alberta

Toolboxes

A Referral and Consultation Process Toolbox has been developed to showcase initiatives throughout Canada to improve the process of referrals from family physician to medical specialists. It highlights success stories and lessons learned. Included are tools that can help doctors address challenges related to improving intra-professional communications, measuring Wait 1, and developing tools like central intake systems and physician directories.

The Referral and Consultation Process Toolbox was created by the Canadian Medical Association (CMA), College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC), with funding from Health Canada.

The Heart Failure Referral Form was developed by the CMA in cooperation with family physicians and cardiologists across the country, and endorsed by the Canadian Cardiovascular Society. The form is a referral checklist that family doctors can use to ensure that relevant information accompanies this type of referral request.

Reports

• Alternate level of care (Access to Care for the Ontario Hospital Association) (2015)
• Canadian Institute for Health Information reports, analysis and resources
• CMA Report (prepared by The Centre for Spatial Economics) “The economic cost of wait times in Canada” (2008)
• Canadian Medical Protective Association Report: “Wait Times: A Medical Liability Perspective” (2007)
• Health Council of Canada reports on access and wait times
• Patient’s Medical Home (CFPC)
• Primary Care Wait Time Partnership (CMA-CFPC) Report “The Wait Starts Here”
• Taming of the Queue
• The Canadian Way: accelerating innovation and improving health system performance (Health Action Lobby) (2014)
• Unleashing innovation: excellent healthcare for Canada (Advisory Panel on Healthcare Innovation) (2015)

Articles

Emergency Departments

• Emergency department overcrowding and access block (CAEP)

Family Medicine

• When the clock starts ticking: Wait times in primary care. Discussion Paper (CFPC)
• Guide to enhancing referrals and consultations between physicians (CFPC-RCPSC)

Cardiac Care

• How established wait time benchmarks significantly underestimate total wait times for cardiac surgery
• Improved Wait Times for Coronary Revascularization: Cause to Celebrate Spotting the Iceberg in Time or Time to Look Under the Surface?
• In search of ‘truth’ and standards for reporting cardiac procedure waiting times
• Monitoring Wait Times for Transcatheter Aortic Valve Implantation: A Need for National Benchmarks
• The politicization of the wait times issue – and how to rise above it
• Timing of Surgery in Valvular Heart Disease: Prophylactic Surgery vs Watchful Waiting in the Asymptomatic Patient
• Treating the right patient at the right time: Access to cardiac catheterization, percutaneous coronary intervention and cardiac surgery
• Treating the right patient at the right time: Access to cardiovascular nuclear imaging
• Treating the right patient at the right time: Access to echocardiography in Canada
• Treating the right patient at the right time: Access to heart failure care
• Trends in Wait Times for Cardiac Revascularization
• True versus reported waiting times for valvular aortic stenosis surgery
• Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation
• Wait times for cardiovascular procedures

Digestive Health

• Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy
• Canadian Association of Gastroenterology Wait Times reports and articles

Paediatric Surgery

• Development of pediatric wait time access targets
• Empirically derived maximal acceptable wait time for surgery to treat adolescent idiopathic scoliosis
• Waiting for children’s surgery in Canada: the Canadian Paediatric Surgical Wait Times project
• Pediatric Surgical Capacity and Demand: Analysis Reveals a Modest Gap in Capacity and Additional Efficiency Opportunities
• Identification and use of operating room efficiency indicators: the problem of definition
• Children are waiting for care and answers
• What’s the Best Way to Allocate or Block Time? A Data Driven Approach to Departmental “Operations”

Multimedia

• Canadian Institute for Health Information Ourhealthsystem.ca
• Health Council of Canada “Innovations in Reducing Wait Times” video series:
  • Building Access to Specialists Care through eConsultation
  • Home First
  • How Queuing Theory Can Improve Wait Times
  • Innovations in Reducing Wait Times (Thompson, MB)
  • Innovations in Reducing Wait Times (St. John’s, Newfoundland & Labrador)
  • Innovations in Reducing Wait Times (Vancouver, BC)
  • The Saskatchewan Surgical Initiative
  • Why the long waits in Canadian healthcare?

• iPolitics webcast: Access to Care — Reducing Wait Times (2012)
• Canadian Institute for Health Information Wait Time Website
• CIHR Institute of Health Services and Policy Research (IHSPR) Policy Rounds webinar “Improving Wait Times: Single-entry models for hip and knee replacement patients”

Related Resources

• ImagiNation Challenges
• Canada Health Infoway
• Choosing Wisely Canada
• Canadian Medical Association MD-MP Contact Program
• Code Gridlock: Why Canada needs a national seniors strategy. Address to the Canadian Club of Ottawa by Dr. Christopher Simpson (2014)