Queue Flashcards
What can the framing be with this issue
You could send patients to other centers where demand is not so great but ethical issues with this
What are HRR issues
adress shortages
improve pay
extend length of time imaging machines were running
What are key ideas in queue theory
Customers
Input source
Queue discipline (different types of queus)
Service mechanism
Ethics
How do we look a policy theory for this issue
Usually look at line from a nuts and bolts perspective not usually a crical lense
Very utilitarian
What are the three components of queu theory
Rate at which patients arrive
The number of health care professionals in the systme
Rate at which patients are treated
When are rates lower
During the summer less people are sick
What is the value of p
P must be less than one as p approaches 1 the entrance rate = the exit rate
What is OCEAN
A self-referral online system if you needed a new knee or hip you had to havea physician put you into a system
What are the 5 mechansims to reduce wait list
- Decrease patient arrival rate
- Increase the treatment rate
- Increase the number of health care providers in the system
- Limit the number of patients in the queue
- Modify the queue discipline
What is under the ECFAA
Policy regulation is under the provincial level it is the excellent care for all act and applies to any hospital in ontarial
What must hospitals due under the ECFAA
Establish quality committees
Put annual quality imrpovement plans in place and make these available to the public
Link executive compensation to the achievement of targets set out in the quality improvement plan
Put patient/ care provider satisfaction surveys in place
conduct staff surveys
develop a declaration of values following public consultation if such a document is not currently in place
establish a patient relations process to adress and improve the patient experience
How do we manage the queue discipine
Priority
What is wait 2
When someone says yes to your surgey and then to the day of your surgery it is easier to measure
What is alternative level
They cant make you any better why are they sitting in a patient bed with a new knee but not moving them out because there is not enough space to put these people
What is ALC
measure the number of days they are sitting in the bed that they do not need
What is ECTAS
you are scored on this when you go in 1 if you are deathly ill
Why is understanding of wait times in important for consumers
Control - estimating when the service you need will happen means you don’t have to put your life on hold
Awareness - seeing how the wait time at your hospital compares to other
Peace of mind understanding why you may need to wait can help put you at ease because your wait time will be apporporiate for your condition
What is wait time
Wait time is the amount of time you have to wait for surgery/exam
Wait is measured from the time your surgery/ exam is booked until the time it is received
If several surgeries or exams are required each one may have its own time
What are the goals and strategic objectives
Person centred
Safe
Equitable
efficient
Effective
Timely
What is Wait 1
Data referral for new consultation is received to the date the patient had their first surgical consulatiaon minus any DARCS
Harder to measure not as relialble
What are DARCS
Dates affecting readiness to consult patient related delay reasons not heart attack weight you forgot to show up collected retrsopectively so harder to measure
What is wait 2
Number of days from decision to treat to OR Date minus and DARTS
What are DARTS
Adds surgery sometimes you need to have a tumor removed before you can have a surgery things like that
What are the prorties
4 you wait the longest
What are the required date entries for wait 1 and 2
Referral date
Consult date
decesion to treat date
surgery date
What are some examples of DART
Developmentally Appropriate Wait
Inabillity to Contact the Patient
Change in Medical status
Missed surgery
Patient choose to defer
Other surgical procedue
How should Wait 1 priority level be assigned
Priority levels description and priortization guidance were created by an expert panel of clinicians to help guide the professional decision making of clinicians in ontario clinicans exercise their own judgment
What metrics do we use
We look at the 90th percentile what the 9th patient would wait gives a more accurate representation
What is throughput
Ratio fo closed cases to new cases added the waitlists
Priority 1 is excluded
If people are leaving faster than they are adding it will be shorter
Opposite of qeue theory
What does 1 mean in throughput
More cases were removed from the wait list than were added during that period
What is ratio less than one
Indicated that the waitlist grew during the periods
