Factors | Actions/Activities |
---|---|
High level coordinating, reporting monitoring structures | • Advisory Committee established, including VP of Acute Care, Directors, and Provincial Wait Time Manager, monthly meetings |
• Regular reporting of progress to Regional Surgical Services Leadership Team and Acute Care Directors Committee | |
• Quarterly updates provided to CEO, Board of Trustees and Ministry of Health | |
• Indicator added to organizational Strategic Plan and Scorecard for three-year cycle (April 2011-2013) | |
Stakeholder engagement | • Numerous meetings and presentations to internal staff, including nurses, doctors, allied health and support staff |
• Presentation to Minister of Health | |
• Briefing note/budget submitted | |
• Regular meetings with Vice President | |
• Meeting with past President of NL Medical Association | |
• Presentations to Community Medical Advisory Committee | |
• Department of Health Sponsor / meetings with Wait Time Management Coordinator | |
Strong management and clinical leadership | • Project Steering Committee established |
• Direct reporting to Vice President | |
• Director & Clinical Chief of Surgery - Project Sponsors | |
• Project Lead hired to support project | |
Dedicated and stable decision making and management structures | • Advisory Committee established |
• Project Team | |
• Director & Clinical Chief members of Advisory Committee | |
Consultation with frontline actors | • Presentation to Orthopedic Education Days and Surgical Rounds |
• Weekly meetings with frontline stakeholders to establish algorithm for new referral practice, including clerical staff, allied health disciplines and managers | |
• Monthly consultation and in-servicing to relevant program staff along the continuum | |
• Standard Referral Working Group | |
• Inpatient Working Group | |
• Orthopedic Charge Nurses, clinical staff participating in site visits | |
• Established formal orientation package for assessment by clinic staff | |
• Assessment clinic education day organized to facilitate clinical skills upgrading and clinical practice review | |
• Cross-site / multi-program working group | |
• Meetings with surgeons’ secretaries | |
Physician involvement | • Presented at Surgical Teaching Rounds |
• Meeting with each surgeon individually | |
• Physician sponsors/ champions identified | |
• Developed a broad based communication strategy targeting multiple mediums to facilitate physician engagement and communicate planning including: | |
 ✓ Visits to urban and rural family physician clinics | |
 ✓ Family Physicians invited to participate in developing algorithm for changes to referral practices prior to development of referral tool | |
 ✓ Anesthetists / surgeons working group | |
 ✓ Teleconferences / site visit for anesthetist | |
• Surgeon Champion appointed to establish strong leadership and obtain buy-in for Central Intake Process | |
• Provincial Medical Association engagement: collaboration with the Communications team to communicate central intake information tools and updates to physicians via web-based media and provincial newsletters to membership | |
Funding levels and earmarked resources | • Budget request for Project Team 2011/2012 - approved |
• Department of Health funding for Project Lead | |
• Health Canada funding obtained | |
Appropriate levels of dedicated staffing | • Increased staffing to facilitate enhanced clinical capacity for assessment clinic and to establish formal interdisciplinary case management |
• Funding secured for two-year pilot with dedicated staff | |
• Project Lead - funded for additional year | |
• Clerical Position allocated for data collection | |
Flexible, adequate capacity | • Orthopedic clinic space renovation: increased space for increased clinic capacity by nine half-day slots |
• Evaluation of existing clinical booking practice to redistribute patient ratios, improve efficiency, and increase capacity | |
• Additional orthopedic operating room capacity assigned (34% increase including dedicated trauma time) | |
• Additional inpatient bed capacity | |
Individual and unit/team incentives | • Adult Orthopedic Team - CEO Award for Team Excellence |
• ‘Improving Access’ poster presentation selected for Taming of the Queue, 2012 – Ottawa. | |
• Key performance indicators collected and shared with team to support improvement | |
Central Registries (the collection and standardization of data) | • Wait Time 1 defined |
• Data fields incorporated into standardized referral tool to collect Wait Time 1 | |
• Central Intake Registry established | |
• Orthopedic Wait List Data Value Stream Map Session: Full day event organized for all stakeholders | |
Standards and guidelines | • Development of algorithms, pathways for central intake process |
• Evaluation Framework developed | |
• Guidelines for completion of standardized referral tool | |
• Definitions for Wait 1 and Wait 2 | |
Information Management Systems | • Represented on working group |
• Meetings with IMT representative ongoing | |
• Site Visit (Holland Clinic, Toronto) for demonstration of | |
• Central Intake Booking System | |
Training and support | • Site visits to Edmonton, Halifax, Toronto, and Vancouver |
• Participation in National Best Practice Initiative – Bone and Joint Canada: representation from all allied health disciplines, surgeons and medical staff. | |
• Best Practice Toolkit introduced: Bone and Joint Canada coordinators invited to participate in multisite education event |