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Alan Hudson
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ABSTRACT: The authors of this article are to be congratulated for analyzing key data, reiterating the major reasons for emergency department (ED) overcrowding and presenting their results in such a way that rational management decisions can be made that focus on solutions.
Healthcare quarterly (Toronto, Ont.) 02/2009; 12(3):107-9.
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ABSTRACT: How many days would you be comfortable waiting if you needed cancer surgery? What would you do if someone, not as medically urgent, was able to receive an MRI or CT scan before you? Would you want to know if you could wait less time for treatment at another location or with another clinician? These are some of the dilemmas facing patients and our health system when dealing with the issue of wait times. To address these pressing concerns, in the fall of 2004, Ontario launched its Wait Time Strategy. Two years later, Collins-Nakai et al. (2006) reported that Ontario had moved "from being a laggard to a leader" with respect to wait times. This article summarizes Ontario's work to date to improve access to care, including reviewing the need, action taken and the emerging results. Much can be learned and leveraged from the experiences described in this article and throughout this issue. They can serve as an important starting point for further discussion, improvement and action, for initiatives big and small, by all types of organizations and jurisdictions.
Healthcare quarterly (Toronto, Ont.) 02/2009; 12 Spec No Ontario:8-15.
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ABSTRACT: Coaching has traditionally been associated with sports, where coaches help teams and individuals focus on improving their athletic performance and achieving top results. Coaches do not play the game; rather, they stand on the side and provide advice and guidance to those who are playing. Increasingly, organizations are recognizing the value of coaching to develop and train leaders, managers and employees to become top performers. Ontario's Wait Times Strategy--which was launched in November 2004--adopted the concept of coaching to help hospitals improve access to services and reduce wait times.
Healthcare quarterly (Toronto, Ont.) 02/2008; 12(1):48-54, 2.
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ABSTRACT: It is widely recognized that Ontario's Wait Time Strategy is a significant change management initiative. But has the province achieved the goal that it set out for itself in November 2004? This article answers this question, beginning with a brief overview of the major inputs or foundational building blocks of the strategy, followed by a detailed analysis of the major outputs or outcomes of the strategy to date.
Healthcare quarterly (Toronto, Ont.) 02/2007; 10(2):58-67, 4.
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ABSTRACT: Morgan, Zamora and Hindmarsh make a compelling case for a national strategy on chronic disease prevention and management. The truths raised in the lead paper are not particularly inconvenient, but they do raise a number of uncomfortable questions: (1) Why are physicians not taking a more responsible and active role to prevent and manage chronic diseases on behalf of their patients? (Physicians must recognize that it is their professional responsibility and their job to provide their patients with the appropriate level of care for chronic conditions.) (2) Why are non-physician healthcare providers not playing a larger role to prevent and manage chronic diseases? (3) Why is there a greater focus on managing chronic diseases than on preventing or delaying them from happening? (4) Have we forgotten the profound impact of the social determinants of health on illness, life expectancy and death?
HealthcarePapers 02/2007; 7(4):29-33; discussion 68-70.
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ABSTRACT: Ontario's Wait Time Strategy--a significant change management initiative--is designed to improve access to healthcare services in the public system by reducing the time that adult Ontarians wait for services in five areas by December 2006 (cancer surgery, cardiac revascularization procedures, cataract surgery, hip and knee total joint replacements, and MRI and CT scans). These five are just the beginning of an ongoing process to improve access to, and reduce wait times for, a broad range of healthcare services beyond 2006. Change management initiatives are initially successful because of the significant time, attention and resources that are dedicated to the start-up effort. Many initiatives lose their momentum and impact and ultimately fail in the long run since it is difficult to sustain this level of intensity. The probability of success increases if a culture is developed to sustain the initiative into the future. A pivotal element for this sustained culture is accountability for achieving results. If Ontario is to reduce waits for quality healthcare services over the long term, it must shift from a paradigm where no one--or only a few--are accountable for achieving a particular set of results to one where a wide range of players is accountable for achieving a broad range of results. This includes explicit accountabilities of the public, healthcare providers (including physicians, other healthcare providers, professional associations and regulatory bodies), government and Local Health Integration Networks. Tools required to support these accountabilities include developing leaders, aligning incentives to reinforce what needs to be achieved, and developing information systems to provide the data needed to make decisions, and manage and improve performance.
HealthcarePapers 02/2006; 7(1):8-24.
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ABSTRACT: Expert panels have been widely used in healthcare as a way of bringing knowledgeable people together to examine issues and identify solutions in well-defined areas. Various terms have been used to describe these groups of experts such as "consensus panels," "blue ribbon panels" and "expert committees or panels." Regardless of the term used, panels of healthcare experts have a history of providing invaluable advice to policy- and decision-makers.
Healthcare quarterly (Toronto, Ont.) 02/2006; 9(3):43-9, 2.
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ABSTRACT: Ontario's Wait Time Strategy was designed to improve access to healthcare services in the public system by reducing the time that adult Ontarians wait for services in five areas-cancer surgery, cardiac revascularization procedures (cardiac surgery, percutaneous coronary intervention, diagnostic catheterization), cataract surgery, hip and knee total joint replacements and MRI and CT scans. These five are just the beginning of an ongoing process to improve access to, and reduce wait times for, a broad range of healthcare services.
Healthcare quarterly (Toronto, Ont.) 02/2006; 9(2):44-51, 2.
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ABSTRACT: As part of its Wait Time Strategy, the Ontario Ministry of Health and Long-Term Care provided significant amounts of money to perform more cases with the understanding that improving access by reducing wait times is not just a matter of increasing funding. Rather, fundamental system and practice change is required to sustain improvements in the long term.
Healthcare quarterly (Toronto, Ont.) 02/2006; 9(4):37-45, 2.
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ABSTRACT: This paper draws upon experience gained in the recent restructuring of cancer services in Ontario that can provide insights for broader regionalization efforts. Although Ontario is the only province in Canada not to regionalize its healthcare system, the Ontario cancer services system, like most others in Canada, is based on a regionalized system. However, the growing burden of cancer and predictable crises in cancer services in Ontario necessitated a rethinking of how the cancer system should be structured and how services should be delivered. Based on recommendations by the Cancer Services Implementation Committee in 2001, Ontario's cancer services system has recently gone through major restructuring, which has established new institutional arrangements for the Ministry of Health and Long-Term Care, Cancer Care Ontario (CCO) (the provincial cancer agency) , a new Quality Council and 11 new regionally based Integrated Cancer Programs (ICPs). This restructuring has created several levers for promoting regional change and motivating performance improvement, including (1) public reporting on performance with a new quality mandate, (2) fiscal and performance-based agreements between CCO and the ICPs, (3) leading and coordinating communities of practice and (4) direct ministerial access. While institutional relationships are still developing, these experiences may provide important insights for regionalization efforts in other jurisdictions and sectors in Canada.
HealthcarePapers 02/2004; 5(1):69-80; discussion 96-9.
