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Wait time strategies

Provinces given “F” for cardio wait-times

OTTAWA – While the Canadian Cardiovascular Society (CCS) gives provincial governments an “A” for meeting or exceeding the benchmark for access to cardiac bypass surgery (CABG), it thinks that an “F” is a fair grade for governments’ failure to look at the “big picture” of cardiac care that is provided to patients.

Dr. Blair O’Neill, Chair of the CCS Access to Care Working Group, said “Adopting a benchmark for CABG is a good start. But the First Ministers originally promised to address cardiac care, so the CCS developed patient-centred benchmarks for cardiac care – which encompass a broad range of services and procedures.

“This included benchmarks for referral to a specialist upon a patient’s first symptoms, right through to completion of rehabilitation and return to a healthy and productive life.

“Yet, by choosing a surgical procedure such as CABG, which is performed on only a limited population and is no longer as common as procedures such as angioplasty, governments are not making a meaningful and positive impact on wait times for Canadians – one in three of whom will die from heart disease. CABG is important but only one narrow aspect of cardiac care.”

“Also,” added Dr. Chris Simpson, Co-Chair of the Working Group, “access to CABG was already an “A” before the First Ministers adopted the benchmark, so the bar was set pretty low to begin with. What we’d like to see is the full spectrum of cardiac-care benchmarks adopted by all provinces, and as part of the pan-Canadian Heart Health Strategy that is currently under development.”

The CCS looks forward to contributing to further dialogue on wait time strategies for the cardiovascular healthcare of all Canadians. Please go to www.ccs.ca for a copy of the CCS’s benchmarks and a commentary on wait times.

The CCS is the national voice for approximately 1600 cardiovascular physicians and scientists. The CCS mission is to promote cardiovascular health and care through knowledge translation (including dissemination of research and encouragement of best practices); professional development; and leadership in health policy.

The Canadian Cardiovascular Society (CCS) is a member of the Wait Time Alliance (WTA). The Canadian Medical Association formed the WTA in 2005, in response to the First Ministers’ commitment to develop benchmarks for medically accepted wait times in five priority areas, including cardiac care. Please see: www.cma.ca for more details about the WTA.


CCS Benchmarks for Access to Cardiovascular Care

The CCS has developed a comprehensive range of patient-centred and evidence-based benchmarks. These benchmarks are published in the CCS report, Universal Access, but When? Treating the Right Patient at the Right Time, (see www.ccs.ca). They were also published in the WTA’s August 2005 report, It’s About Time!


The “Patient’s Journey”

The CCS’s benchmarks for access to care reflect the many steps that patients take to receive cardiovascular healthcare services and procedures. The patient’s journey is about many steps – not just one, (such as access to cardiac bypass surgery). The patient journey begins with the first visit to a primary healthcare provider, then to a specialist, then through many additional steps including testing, procedures and surgery, and finally to completion of rehabilitation and return to a healthy and productive life.

Unless all steps in a patient’s care are addressed, optimal care cannot be provided. For this reason, the CCS stresses that all of its benchmarks must be adopted to truly have a meaningful impact on patients’ access to cardiovascular care. This is the “big picture” of cardiac care for patients. The CCS believes that wait times for most, if not all other areas of care, are also about the patient’s journey, (and not just one procedure or service).

Cardiac bypass surgery (CABG), while potentially life-saving and very important for some patients, is a procedure that is necessary for only a small proportion of patients accessing cardiac care in Canada. Most patients require other services.

Angioplasty, for example, a procedure involving the opening of an artery with a balloon via a catheter, is twice as common as CABG, and is not addressed at all in the WTA report card. Addressing only the wait for CABG (as governments have done) will not address the wait time to see a cardiologist, or to have other required tests (such as a stress test, an echocardiogram, a cardiac catheterization), or a therapeutic procedure for other cardiac conditions.

The CCS is a partner in the development of the Canadian Heart Health Strategy to fight cardiovascular disease in Canada. See: www.phac-aspc.gc.ca.

 

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