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Health Care System Challenge: Orthopedic Surgery Wait Times (Main Actors…
Health Care System Challenge: Orthopedic Surgery Wait Times
Main Actors and Structures/Processes
Family doctor
(refers patient to a specialist in orthopedic surgery)
Orthopedic surgeon
(the specialist who will be operating on the patient)
The
process
of waiting between the time the orthopedic surgery referral was made to the first appointment with the orthopedic surgeon
The
process
of waiting to receive test results (i.e. X-ray, MRI) or having further consultations before a surgery is scheduled.
The
process
of waiting to have the orthopedic surgery upon scheduling it.
Hospitals
(the location in which orthopedic surgeons perform surgery on patients; however, not every hospital will have specialists who can perform surgery)
Patients
(those who desire or are in need of orthopedic surgery)
Healthcare managers
(i.e. policy makers, administrators; are the ones who are involved in the processes necessary to manage the healthcare delivery system)
Multiple Multi-Way Interdependencies Among Actors and Structures/Processes
Patients
depend on family physicians to refer them to a specialist in orthopedics
depend on orthopedic specialists for their surgery
depend on healthcare managers to access and navigate the healthcare system.
Family doctors
depend on healthcare managers as they manage the system under which the family physicians practice
depend on an influx of patients to maintain their practice as a family doctor
depend on orthopedic specialists to receive and respond to their referrals
Orthopedic surgeons
depend on patients to attend their referral consultations and other patient responsibilities/obligations
depend on family physicians to send referrals
depend on healthcare managers as they manage the system under which the orthopedic specialists practice
Barriers to Integration of Healthcare
Lack of coordination between key actors
The lack of coordination amongst key actors (i.e. family physician, specialists, healthcare managers) in a patient's journey to receive health care is not only a symptom to lack of integration of health care but also a barrier.
Unclear financial attribution
Often many health systems have preexisting divisions in financing, management structure, and care provision, which may preclude the implementation of integrated care.
Cultural inertia
A change of culture is required, at both clinical and management levels, without which may lead to a lack of shared vision and problems in the long-term sustainability of integration.
Potential Enablers of Integrated Healthcare
Accurate patient information electronically transmitted in a timely fashion
Leverage and integrate information and communication technologies for wait time management with the pan-Canadian electronic health record infostructure currently being implemented across the country.
Strong collaborative leadership
The implementation of a pan-Canadian wait time management system will require strong collaborative leadership from all jurisdictions within a national forum
Redesign of healthcare provider business processes
Information technology solutions will need to enable and support these new processes.
References:
https://www.tandfonline.com/doi/full/10.1080/23288604.2015.1077301
https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/addressing-wait-times-information-technology.html
https://theconversation.com/how-to-solve-canadas-wait-time-problem-96170