Wait times strategy ahead of schedule, doctor in charge says

The province has had to build a system from scratch to manage surgery waiting times , and now work on the Ontario Wait Time Strategy has gone “way ahead” of schedule, says Dr. Alan Hudson, the strategy’s lead of access to services/wait times.

Dr. Hudson was in North Bay Friday to talk to local hospital and health care officials about the strategy and local health integration networks.

“We’re way ahead of where we were thought we were going to be on the strategy at the end of one year,” Hudson said during an interview.

“We’ve got the biggest increase in volume in over a decade in this province, we’re doing a lot more cases we already have a public web site up, and we’re about a year ahead on that,” Hudson said.

Behavioural change
Since he was appointed last fall to develop and lead the strategy, Hudson said the province has funded an “extraordinary” increase in the number of surgeries and procedures being delivered in five key areas: cancer surgery, cardiac procedures, cataract surgery, hip and knee replacement and MRI and CT exams.

The wait times strategy amounts to a “behavioural change” in better understanding efficiency, and better ways of doing things, Hudson said.

“We’ve got all sorts of measurements for efficiency, you had a lot of places that were inefficient and if we can make them more efficient wait times will come down,” Hudson said.

“We also have groups of coaching teams and these are nurses and providers going to hospital at the moment by invitation to see if they can help them with their efficiency and their process.”

Give them money
Up until the strategy’s implementation, Hudson said, there had been no system for tracking surgical wait times, and they had been the private domain of surgeons.

“The whole shift now is to the purchaser of the procedure, so the patient is empowered and has some choice,” Hudson said.

The province used a carrot, he added, to collect wait times from hospitals.

“We give them money,” Hudson said.

“We said to them ‘you want the money, give us the information.’ We said ‘you agree to do x more cases and we give you the dough on the condition you give us the wait times for more cases and your base cases, and if you break the contract we’ll take the money away,’ and that’s how we got the information.”

Paying for it
Hudson, who spent almost 20 years as a neurosurgeon at St. Michael's Hospital in Toronto, said that up until recently, surgeons had been the ones in charge of patients.

“We’re changing from that concept to the person in charge of us is the patient, not the doctor, because it’s a service industry,” Hudson said.

“You go to a retailer or an airline or a bank, you’re the person paying, you decide what’s going on, because you’re paying for it through your taxes.”

Not happening
Disparity in wait times still exist among different regions, Hudson admits, and the goal remains to establish equity of access for all Ontarians.

“If you have a cataract patient in Windsor or one in North Bay, the idea is they’re both operated on in approximately the same time,” Dr. Hudson said.

“That’s not happening by a country mile, we have situations where there’s a six-fold difference in wait times between institutions that are a half-hour apart.”

Fail to decrease
Right now hospitals deliver wait times to the province, but that will change as local health integration networks (LHIN), which came into being across Ontario Thursday, gradually begin managing funding for health care in their areas.

LHINS can then begin investigating if waiting times in their hospitals fail to decrease.

All operations
Hudson has another year to go on his mandate, he said.

Then the province will have to decide what his next assignment will be in continuing to develop the wait times strategy.

If he has his druthers, Hudson said, he’d like to expand the wait times list to go beyond the five surgical procedures on it now to include all operations done in the province.

“The reason I want to do this is because I have some people who say ‘it’s fine that you get those wait times down but other wait times are going to go up,’ you squeeze the balloon over here and it expands over there,” Hudson said.

“If you measure all in fact you can see what the facts are, is that happening, yes or no, so that’s what I’d like to do and that’s the idea of this project.”

Click here to access the Ontario Wait Times Strategy.