Wait Time Project Implementation Strategy

Implementation Plan: Goals 1.To educate and provide clarification around the wait time project, wait time definitions, indicators, data collection and data entry. 2.To come to a consensus around the clinical interpretation of the wait time definitions and indicators to ensure consistent data reporting across the province. 3.To ensure consistent and accurate data collection and data entry in order to have consistent reporting across the province. 4.To develop and implement strategies around ways to perform within the TWT at the Local, Regional, and Provincial level.

Implementation Plan for Goals 1 & 2 Host Provincial educational workshops Rigorous follow up with individual centres following workshop to assess where additional education and clarification is required. Developing detailed examples to guide interpretations for routine and special circumstances. (provide DTT/RTT date exp)

Implementation Plan for Goal 3 Conducting a review of institution specific systems where there are issues around data capture and propose workable solutions. (i.e. VARiS and IMPAC for RT) Developing automatic and manual process to catch errors at source. Developing data quality protocols that include returning poor Quality data to the source. Brokering relationships with various vendors and ICPs. Developing audit and accountability mechanisms that improve data quality and eliminate potential gaming of the data.

Implementation Plan for Goal 4 Collaborative effort to: –Exchange/Share best practices and innovative solutions for wait times reduction across the province. –Develop a plan to phase in targets over time (locally, regionally, and provincially).

Implementation Strategy Cont’d To lay out a coordinated approach for using the tools developed by the WT Project to reduce wait times for cancer surgery, radiation and systemic treatment. In scope are: An Accountability Framework: Vision & principles for wait time management and agreement on roles and responsibilities for the parties that will participate in the implementation of the target maximum wait times and will be accountable for achieving a reduction in wait times A Communication Plan: To whom and how we will communicate about the access to care framework, the new wait time definitions, urgency categories, target maximum wait times and system performance goals. A Work Plan: An overview of tasks and timelines required to ensure supporting processes and infrastructure are put in place

Guiding Principles Responsibility to reduce wait times is shared by the Government of Ontario (MOHLTC and MTCU), CCO, clinicians and administrators. All stakeholders need to work together to drive improvement. All parties will have clear roles in the timely generation, use and evaluation of high quality wait time data. All parties will be held accountable to fulfilling these obligations. Deviations from the targets will be addressed immediately through a clearly defined process that will include root cause analysis and concrete action plans that are implemented in a timely fashion to improve wait time performance. Target maximum wait times will be updated regularly to reflect the most recent evidence and clinical consensus available. The system must provide appropriate incentives and disincentives to drive needed behavior to reduce wait times.

Wait Times Implementation 06/07: Roles & Responsibilities Together we will –Set regional targets for 06/07 and work toward meeting them –Take action to meet the targets CCO will –Provide educational support regarding new data elements and indicators –Design and implement a data quality assurance program –Review and revise wait time reporting RCPs will –Provide input into wait times reporting changes –Implement ready-to-treat date and urgency ratings When targets are not met –Conduct root cause analysis and develop action plans for issues within local control (RCPs) and system-wide (CCO)

Direct Responsibilities ClinicianDeliver service, record data, implement improvement plans, communicating with individual patients. HospitalAllocate resources to meet targets, implement improvement plans. Collect and report hospital data. Hold clinicians accountable. CCO-RVPMonitor data, oversee root cause analysis, develop action plan for local and regional issues. Broker knowledge and champion solutions regionally. LHINTo be determined. CCO-Prov’l Team Support inter-regional knowledge brokering. Set and maintain provincial targets. Collect and report provincial data. Report to the public (shared with government) Develop action plan for system-wide issues. (Includes advising government on policy and resource allocation through the OCP) Enforce relevant contractual obligations. Hold RVPs accountable. GovernmentSet system priorities and make resource allocations (Operating, capital and HR resources). Hold CCO accountable. Public reporting (shared with CCO).