| Popis: |
For over a decade, industrialized countries around the world have struggled to solve the problem of long wait times for scheduled medical care (Siciliani and Hurst 2003). Canada's recent history in the matter is a study in paradoxes. On the one hand, Canadian decision-makers appear to have agreed that the answer to the problem of waiting lists and wait times lies at the federal and provincial levels, and recent Canadian wait time initiatives have consistently looked to centralized programs as their solution (Health Council of Canada 2007; Health Canada 2004; SCC 2005; Prime Minister of Canada 2007). On the other hand, recent findings suggest that the success or failure of a given wait time management strategy (WTMS) depends less on federal or provincial policy than on how the strategy is implemented in healthcare organizations (HCOs) themselves. The results of Ontario's Wait Times Strategy initiative, for example, reveal that HCOs were the key players in the program's success, and it was only after a significant investment of time, attention and resources that organizations adopted an accountability framework that allowed them to execute the program and meet the provincial government's objectives (Trypuc, Hudson et al. 2006; Trypuc, Hudson et al. 2007). It seems clear, then, that we must pay closer attention to the factors that facilitate or impede the implementation of WTMS in HCO (Ferlie and Shortell 2001). For that reason, this paper describes what WTM experts from different levels of Canada's healthcare system perceive as factors in the success or failure of WTMS, and how they feel these factors interact to facilitate or impede the implementation of WTM programs within HCOs. |
