Information
March 2007
Patient Wait Times Guarantees
Patient Wait Times Guarantees (PWTGs) are important tools to help provide certainty for patients, build public confidence in the public health system and enhance system accountability. As international experience has shown, PWTGs can be designed to meet particular needs as part of a multi-pronged access strategy.
In order to fulfill the above intended objectives, PWTGs should include the following core elements:
- a defined timeframe to establish when medically necessary health care services should be delivered; and,
- access to alternative options of care that are automatically offered to patients if the system fails to deliver treatment within the defined time frame.
Timeframe
A defined timeframe would ideally be informed by scientific evidence, clinical consensus as well as other jurisdictional considerations (i.e., capacity). Evidence-based benchmarks would therefore continue to function as the guide posts for the timely provision of care with targets indicating how jurisdictions plan to achieve the benchmarks. The defined timeframe would build on the common benchmarks and provincial/territorial wait times targets and complement the overall strategies to improve timely access to required health services (i.e., appropriate referrals/service use, clinical thresholds for getting on a wait list, centralized tracking).
However, a defined timeframe without the offer of access to alternative care options does not represent a PWTG, as it does not help to provide certainty for patients.
Access to alternative care options
Access to alternative care options (recourse) would give patients the certainty that should their wait time exceed the defined timeframe, the system would automatically respond by offering options for obtaining timely care (e.g., ranging from access to another provider within the same institution, through to service outside the jurisdiction). Patients would not need to initiate a process for recourse on their own. Whether or not the patient accepts such alternative care options, however, is ultimately their choice.
Existing alongside system-initiated access to alternate care options, patients would continue to have access to processes that they initiate themselves (i.e., ombudsperson, administrative tribunals), although these can be burdensome on patients and involve a more litigious approach.
Current system improvements to monitor and inform patients as they wait for care (centralized tracking/ booking systems, patient navigators) serve to minimize the ultimate need for alternate care options and assist patients as they move through their care journey.
This understanding of PWTGs offers patients increased certainty of timely care while providing provincial and territorial governments considerable flexibility in determining the definition of the timeframe and the range of options for alternative care to be offered. There is also significant flexibility in the services covered and timelines for implementation, recognizing the differing circumstances, starting points and priorities of provinces and territories.
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