1. Alberta Innovates- Health Solutions- KT Webinar OA Team Grant: Project 1 WCWL Investigators Dr Tom Noseworthy March 9, 2011

2. KT in Project 1: Outline WCWL Investigators background AI-HS/CIHR Team Grant Research What are the Project 1 deliverables? What value is anticipated ? Who is the audience ? How are they/will they be involved?

3. WCWL Investigators Team for Project 1 On Behalf Of: Claudia Sanmartin; Barb Spady; Cy Frank; Michael Carter; Gillian Hawker; Deborah Marshall; Carolyn De Coster; Eric Bohm; Mike Dunbar; Sherry Weaver; Diane Lorenzetti; Marie-Pascale Pomey; Peter Faris; Tom Noseworthy

4. WCWL Mission …improve the fairness of the system such that access to appropriate and effective health care is timely and prioritized on the basis of need and potential to benefit.

5. Managing Waiting Times for Scheduled Services Question addressed Should this patient be placed in the queue? What is the correct order for the queue? How long should this patient wait? Can we offer a certain waiting time? What can make the waiting time experience better? WCWL research program * (Funded by AI-HS & CIHR) Appropriateness* Priority-setting Maximum acceptable waiting times Operations research and scheduling* Patient expectations*

6. Current Work of WCWL Investigators -focused on hip& knee replacement- (AI-HS & CIHR Team Grants) Appropriateness (Sub-project 1: Sanmartin) Patient expectations (Sub-project 2: Spady) Operations research & scheduling (Sub-project 3: Carter) Successful & sustainable WTMS (Sub-project 4: Pomey)

7. Sub-project Deliverables for Project 1 (AI-HS- & CIHR- funded) Appropriateness:.Multi-stakeholder shared decision aid for appropriateness of TJR Patient expectations:.Waiting time trade-offs for next available surgeon & SEM.Improved management of the waiting time experience Ops & scheduling:.Scheduling system for WRHA.OR tool kit for health authorities.Systems dynamics model for OA Successful & sustainable WTMS.Generalize success.Tool for managers

8. Value Proposition of Deliverables Appropriateness: a decision aid of value to patients’ acceptability; surgeons managing expectations of outcomes; reducing variability; managing supply-induced demand Patient Expectations: better understand & manage the waiting time experience; improve satisfaction with surgical outcomes; inform deliberations around next available surgeon & single-entry models

9. Value proposition of Deliverables Operations Research & Scheduling: offer a definite date for surgery; forecast the future & better planning ; simulate impact of system changes & perturbations Waiting Time Management Strategies: generalize successful & sustainable innovations in access management

10. Sub-project 1: Appropriateness Audience Patients Orthopaedic Surgeons and MSK clinicians Bone & Joint ‘community’ Policy-makers Involvement Focus groups in Halifax, Winnipeg & Toronto Key informants from Halifax, Winnipeg & Alberta Planned re-engagement during tool formulation AHS Clinical Network for MSK Health Taming of the Queue KT Workshop ABJHI & Bone & Joint Canada Canadian Arthritis Network Taming of the Queue Workshop AH&W presentation HC pending

11. Sub-project 2: Patient Expectations Audience Patients Orthopaedic surgeons & MSK clinicians Involvement Focus groups in Halifax, Winnipeg & Calgary Pending patient survey Pending conjoint analysis Key informant interviews on next available surgeon & single-entry models Participation in BJC Through ABJHI, a collaborative resource to AHS clinical network for MSK Health

12. Sub-project 3: Operations Research Audience Managers & planners Policy-makers Involvement Through ABJHI, AHS clinical network for MSK health Communications with WRHA executive Participation in & presentations to Bone & Joint Canada TQ KT Workshop AHS Clinical Network MSK Health Presentations to HC & AHW

13. Sub-project 4: Success & Sustainability Waiting Time Management Strategies Audience Managers & planners Policy-makers Involvement Case studies of s/s of centres across Canada Findings to participants Participation in Models of Care initiative TQ KT Workshop AHS Clinical Network for MSK Health Canada & AHW Provincial Health Ministries

14. Leveraged Grants Abstracts & Publications CIHR: Emerging Team Grant- Noseworthy (PI) AI-HS: SD Model of OA in Alberta- Marshall (PI) AI-HS: KT Grant for SD Model- Marshall (PI) …………………………………………………………………………………………. Abstracts presented* or accepted at ACR*, CRA*, COA 2010*, COA 2011, INFORMS, COMOC*, U of M*, MPA* (MB PT Assoc.), STTI Honor Society of Nursing*, CONA* …………………………………………………………………………………………. Papers : Rheumatology PRS -Arthritis Care & Research-Feb 2011 Patient Choice Systems -Health Care Mgt Forum- Accepted Feb 2011

15. Waiting Time Management Strategies Process redesign & efficiency optimization Single-entry models* Priority-setting tools* Waiting time targets & care guarantees* Patient choice systems* Simulation, scheduling and operations research* Appropriateness* Health promotion & disease/injury prevention * Research by WCWL Investigators