1. Wait Times in Canada:
The Wait Time Alliance
(WTA) Perspective
Presentation to
Taming of the Queue 2012
Dr. Chris Simpson, WTA Chair
March 29, 2012

2. Patients should not wait excessively
for important medical care
Tumour Doubling
Time (weeks) by
520
300 Primary Cancer Site
260
Tumor Doubling Time (weeks)
128 studies of 8071 cases
104
52
30
26
22 21 18
13
12
8
6
4
4
1
Prostate Breast Colorectal Gastric Lung Hepatic Pancreas Head/Neck

5. Current State (October 2007) - % of cases
completed within target
Cancer Surgery
100%
93%
Expected
CT Bypass Surgery
77% 100%
0%
46%
95%
MRI Cataract Surgery
80% 85%
Knee Replacement Hip Replacement
Target Actual
Note: Priority 4 targets used in absence of priority-level data. Angiography and
Angioplasty Cardiac Data are currently unavailable.
5
Source: Wait Times Information Office

6. Wait time guarantees
6 Provinces chose cancer (radiation therapy) as their target
of choice and received share of $500m
Province RT guarantee
PEI 8 weeks
NS 8 weeks
from referral
NB 8 weeks
Man 8 weeks
Alta 8 weeks
BC 8 weeks
* CIHI report: Wait Times Tables—A Comparison by Province, 2007

7. Wait time guarantees – Radiation
therapy
6 Provinces chose cancer and received share of $500m
Province RT guarantee Current wait time *
PEI 8 weeks 2 wk
NS 8 weeks < 4.1 wk
from referral
NB 8 weeks
Man 8 weeks 1 wk
Alta 8 weeks 2-3.5 wk
BC 8 weeks 0.9 wk
* CIHI report: Wait Times Tables—A Comparison by Province, 2007

8. Canadians want PM to place priority on
health care
Survey asked more than 1,200 Canadians to rate on a scale of 1 to 5 how highly they viewed nine
possible priorities for this government. Here are the average scores each priority earned:
• Working with the provinces on health care - 4.32
• Creating jobs through training - 4.01
• Eliminating the deficit - 3.98
• Cutting taxes - 3.69
• Investing in research and development - 3.63
• Getting tough on crime - 3.58
• Focusing on new trade opportunities around the world - 3.48
• Strengthening Canada's armed forces - 3.05
• Reforming the Senate of Canada - 2.99
Source: Nanos Research, Institute of Research on
Public Policy poll June 2, 2011

9. The Genesis of the WTA

10. Who makes up the WTA?
• Canadian Anesthesiologists’ Society
• Canadian Association of Emergency Physicians
• Canadian Association of Gastroenterology
• Canadian Association of Nuclear Medicine
• Canadian Association of Radiation Oncology
• Canadian Association of Radiologists
• Canadian Cardiovascular Society
• Canadian Ophthalmological Society
• Canadian Orthopaedic Association
• Canadian Psychiatric Association
• Canadian Society of Plastic Surgeons
• Society of Obstetricians and Gynaecologists
of Canada
• Canadian Association of Paediatric Surgeons
• Canadian Medical Association (secretariat)

11. WTA History
– Established following First Ministers’ 2004 Accord
with commitment to reduce wait times
– Purpose: Ensure that physicians play leadership role
in patient access (e.g., setting wait-time benchmarks)
– Hold governments accountable on their commitments
to reduce wait times: “Meaningful reductions” in waits
for priority areas (cancer, heart, DI, joint replacement,
sight restoration)

12. Wait Times From the Patient’s
Perspective
WTA wait time definition
Testing
Decision by Family Decision to treat or
physician/GP Specialist Treatment
patient to consultation refer back to family
see family consultation: doctor received
physician Differential
diagnosis &
referral
as needed
Rehabilitation (if necessary) and follow
up with family physician and specialist
Adapted from prototype shared by The College of Family Physicians of
Canada and from ICES, Access to Health Services in Ontario, Fig. 1.1

13. WTA Mission
• The WTA is concerned over delayed
access to care for Canadians. We work
collaboratively with our stakeholders to
inform, advocate, and provide solutions
to achieve timely, appropriate and
equitable access to high quality health
care.

14. WTA Directions
1. Approach wait times from the patient’s
perspective
2. Add the Patient’s Voice
3. Build Partnerships
4. Provide Solutions
5. Celebrate Success

15. WTA 2011 Report Card
• “Time Out!”
• WTA’s 6th annual report assigning grades
• Graded:
– 5 priority areas against government benchmarks
– Additional procedures/diagnoses graded against WTA
benchmarks
– ALC
– Provincial wait time websites
– Links to WTA member leading practices

16. 2011 WTA Report Card
Provincial breakdowns for 5 priority areas

17. WTA’s 5 Year Assessment
2007-2011
National Grades Procedures
Diagnostic
Imaging Joint Replacement Radiation Cataract
CT MRI Hip Knee Oncology Surgery CABG
4 4
weeks weeks 26 weeks 26 weeks 4 weeks 16 weeks 26 weeks
2007 nb nb B B C B A
2008 nb nb B B B B A
2009 nb nb B C A A A
2010 nb nb B C A A A
2011 nb nb B C A B A
5 Year trend nb nb B C B B A
5 Year national
grade: B

18. Table 3: Provincially Reported Wait Times Compared to Select WTA Benchmarks
WTA
Treatment/service/procedure Benchmark NL PE NS NB QC ON MB SK AB BC
Anesthesiology (chronic pain)
Acute neuropathic pain 30 days ? ? ? ? ? ? ? ? ? ?
Cancer pain 2 weeks ? ? ? ? ? ? ? ? ? ?
Cardiac Care (scheduled cases) $ $ $ $ $ $ $
Electrophysiology catheter ablation 90 days ? ? ? ? $ ? ? ? ? ?
Echocardiography 30 days ? ? ? ? ? ? ? ? ? ?
Gastroenterology
Cancer 2 weeks ? ? ? ? ? ? ? ? ? ?
Inflammatory bowel disease (IBD) 2 weeks ? ? ? ? ? ? ? ? ? ?
Emergency Department 4hrs/8hrs ? ? ? ? ? A/F ? ? A/D ?
Nuclear Medicine $ $
Bone scan -whole body 30 days ? ? ? ? ? ? ? ? ? ?
FDG-PET 30 days ? ? ? ? ? ? ? ? ? ?
Obstetrics and Gynaecology $ $ $ $ $
Abnormal premenopausal uterine bleeding 12 weeks ? ? ? ? ? ? ? ? ? ?
Urinary incontinence 12 weeks ? ? ? ? ? ? ? F ? ?
Plastic Surgery $ $
Carpal tunnel release 2 months ? ? $ $ ? ? ? F D ?
Skin cancer treatment 4 months ? ? ? ? ? ? ? B ? A
Pediatric Surgery* $
Advanced Dental Caries: carious lesions/
pain 90 days ? ? ? ? ? $ ? ? ? ?
Cleft Lip/Palate 21 days ? ? ? ? ? $ ? ? ? ?
Psychiatry (scheduled)
Early psychosis 2 weeks ? ? ? ? ? ? ? ? ? ?
Postpartum severe mood disorders 4 weeks ? ? ? ? ? ? ? ? ? ?

20. WTA assessment of wait-time
commitments
• Slight improvement in reported wait times
for 5 priority areas since 2007
• Inconsistent reporting for other specialty
areas; wait times frequently fall outside of
acceptable wait-time benchmarks/targets
• Provincial reporting has improved but
need more consistent and standardized
reporting to properly assess progress
• Need to address regional variations

21. Next Steps: Improving wait time
measures
The WTA will continue to shed light on:
(1) the wait that patients experience for a wider
range of specialty care services (beyond the
initial 5 identified by government); and
(2) the total wait times that patients face in trying to
access specialty care – including access to
primary care, chronic disease management and
end of life care.

22. Canadian Health Care System

23. Toward a new professionalism
• Cost and Benefit together with Care and Trust
– Anchored in accountability
• Civic-oriented professionalism
• Seize the leadership of this issue
– A moral imperative
– A professional responsibility
– A “professional social ideal”

24. WTA website
To access WTA reports, benchmarks,
news releases etc…
http://www.waittimealliance.ca/