Literature Reviews
Findings from WCWL_1
Expert Clinical Input
Patient Input
General Public Input
Other Inputs
The Process
The following have been identified as the key sources of information and sub projects which would be brought together to establish benchmark maximum waiting times.
Dr. Claudia Sanmartin will lead a team of WCWL Associates and colleagues to collect the needed information and develop a method for the wait times. This group would act as consultants to the panel. Areas of expertise include: health services research; economics; ethics; epidemiology, psychometric measurement; and biostatistics.
Literature reviews of the medical databases, the grey literature and reports of government sponsored surveys will be conducted. These will focus on three areas:
 | the impact of waiting on patient health status, on the outcome of the procedure, and the costs of waiting |
| existing methodological approaches to developing wait time standards |
| existing waiting time standards in the WCWL clinical areas |
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| In the course of developing and pilot testing the five WCWL prioritization tools, we obtained opinions of patients and specialists on waiting times associated with certain urgency levels. Further, we have actual wait times associated with urgency ratings from some pilot test centres. This will be summarized and brought forward for consideration by the Waiting Time Panel. |
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| Expert provider panel(s) including specialists, general practitioners, and allied health professionals will be asked to review a set of standardized cases and provide maximum acceptable waiting times. Major joint arthroplasty will be the first clinical case selected and the original WCWL orthopedic panel will conduct these assessments. |
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| A survey of patients who spent time on waiting lists will be conducted to assess their views and experiences while waiting for an elective procedure and to assess their views on acceptability of waiting times. Patients who have been assessed with a WCWL priority score and who have received hip or knee replacement surgery will be eligible to participate. The survey will probe waiting time experiences, health care utilization during waiting period, satisfaction with care received, and patient characteristics |
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| This component seeks to elicit public values for wait time reductions using an economics-based approach and incorporating the idea of opportunity cost. We want to learn how the public values reduction of waiting time in relation to urgency of the case. Further, does wait time reduction vary with other attributes such as certainty of booking time, location of surgery, or choice of surgeon? |
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| An analysis of this project and the issues it raises from an ethics perspective will be undertaken |
| As part of our effort to evaluate the benchmark waiting times, an operations research approach may be employed to test the impact on resources required and other issues that may develop. |
| The project will begin with waiting times for hip/knee replacement and move to other WCWL clinical areas at the request of the Steering Committee. |
| The members of the waiting time panel (WTP) will be nominated by the WCWL Partners and endorsed by the Steering Committee. |
| The WTP will meet several times over the course of the 18 month project. An initial meeting will address the workplan for the project. |
| Each of the sub-projects listed above will be assigned to an individual or team and a detailed work plan and budget will be developed in conjunction with the WCWL Project Director. |
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