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Canadians are aging and the need for total joint replacement (TJR), particularly hip and knee, has increased. The challenge was recognized by the Government of Canada, announcing this as one of five priority clinical areas and advancing a waiting time benchmark of 26 weeks (December 2005). The proposed research will improve both understanding and management of demand and supply for TJR. Focusing on demand, the program will define appropriateness of arthroplasty and develop a decision-support tool for determining it. Appropriateness is a key and under-researched determinant of demand and the definition and tool will include the perspectives of clinicians, patients and policy makers. Focusing on supply of services, the program will develop scheduling systems for TJR, which offer patients a definite date for service, rather than vague placement on a waiting list. This will be combined with other tools and technologies as a toolkit designed to help all Regions improve the timeliness and certainty of services for TJR. Tying together these components of work, the third component is focused on understanding and managing patient expectations and the waiting time experience and what can be done to improve it. Finally, we will examine Regions which have undertaken reengineering and process redesign and attempt to determine what systemic and organization factors sustain successful strategies for waiting time management of TJR. |
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