As I embark on my journey to complete the first of three courses on Health Promotion at Athabasca University, I have chosen to investigate wait times for computed tomography (CT) scans in Southwestern Ontario. As a Director of Diagnostic Imaging and Laboratory in a small rural hospital, it is my role to provide my teams with the tools and resources they require to provide high quality diagnostic services. At the same time, I am responsible for supporting an environment that meets and exceeds the needs of our clients, which include the physicians who are ordering diagnostic studies and the patients, and their families, who require imaging to support a diagnosis of what is ailing them. My north star, or the guiding principle that resonates that will guide me through this topic, is that I truly believe that every hospital that provides CT scans aims to provide high-quality services efficiently, but the unfortunate reality is that wait-times for CT scans vary between organizations, resulting in inequitable access to the CT scan our patients require.
Wait-time, as defined by the Canadian Institute for Health Information (CIHI), is the number of days a patient waited from the date the order/requisition was received in the imaging facility, to the date the patient received the CT scan (CIHI, 2023).
While some waiting for CT scans is unavoidable, Bruni et al (2010) have identified that waiting for care can lead to patient suffering, strained doctor-patient relationships, and significant patient dissatisfaction (Bruni et al., 2010). The Canadian Association of Radiologists (CAR) (2022) have also reported that long wait times for medical imaging is an issue that has put Canada into crisis mode, as our healthcare system is not equipped to handle current volumes and we are at risk of leaving many patients undiagnosed and untreated (CAR, 2022). As Hofmann et al (2023) have identified, the demand for imaging has outpaced the access, resulting in long wait times (Hofmann et al., 2023). In Southwestern Ontario, depending on where you live you may have to wait for a routine, priority level 4 scan anywhere from twenty-seven to two-hundred-and-six days(HQO, n.d.). The defined target for a priority level 4 scan is twenty-eight days (HQO, n.d.). Healthcare leaders must work together to minimize the inequities our patients experience for CT scans.
What are my own personal learning goals and what am I most excited to learn?
For me personally, I look forward to continuing my learning on how to utilize health promotion effectively and efficiently to improve the services my organization provides for our patients and their families. I am also excited to improving my communication skills when dealing with the clients we serve, to ensure patient and physician expectations align with what our diagnostic service is able to provide. I am very process driven and can describe the benefits and barriers to the service my teams provide, both locally and compared to our regional partners. However, I believe I have opportunities to improve when it comes to strategies for proactive, routine and effective health promotion for the patients and physicians we serve. I am excited to work on developing infographics to promote this topic, as they will be valuable both for my academic learning and my professional approach for communicating. Inequitable access to CT scans is something I have been working on for some time and being able to reflect on and use some of the work that has been done within a health promotion framework presents an excellent opportunity to improve the tools I can utilize as a healthcare leader.
Anything making me nervous?
This is my eighth course in my pursuit of a Master in Health Studies from Athabasca University. So far, I have found that each course has improved my understanding of, and approach towards, healthcare leadership. This is the first course I have taken in the summer semester, and I have been very nervous and have found it very challenging, to make the time to prioritize my learning activities. My family lives on a small hobby farm and my three children are engaged in several activities. Given that this time of year is very busy for us, I find myself struggling to maximize my use of the very few hours in a given week I am able to carve out to focus on my studies. This is evidenced by my limited participation in the weekly activities as I struggle to get caught up so I can add meaningful discussion points for my classmates. I am confident I will be able to be successful in this course and remain optimistic I can increase the learning experience for my classmates for the remainder of this course.
What challenges lie ahead as I pursue my chosen health promotion topic?
One of my mentor’s, when discussing quality improvement activities and the role of measuring and evaluating outcomes, used to always say “We don’t know what we don’t know unless we measure it”. Looking ahead, I think the most challenging aspect of my chosen health promotion topic will be narrowing down the focus to be able to effectively evaluate any activities that will be taken to improve the inequitable access to CT scans across Southwestern Ontario. Even now I find myself considering ways to improve the focus of my chosen topic so I can effectively build a framework to truly address at least one element of this topic effectively. Regardless, I do look forward to improving my understanding of health promotion so that I can continue my development as a healthcare leader.
REFERENCES
Bruni, R. A., Laupacis, A., Levinson, W., & Martin, D. K. (2010). Public views on a wait time management initiative: A matter of communication. BMC Health Services Research, 10. https://doi.org/10.1186/1472-6963-10-228
Canadian Association of Radiologists. (2022). Addressing the Medical Imaging Dilemma in Canada: Restoring Timely Access for Patients Post-Pandemic. https://car.ca/wp-content/uploads/2022/02/CAR-PreBudgetSubmission-2022-e-web-FINAL_edited_Feb.pdf
Canadian Institute for Health Information (2023). Wait Times for Priority Procedures in Canada — Data Tables. https://www.cihi.ca/sites/default/files/document/wait-times-priority-procedures-in-canada-2023-data-tables-en.xlsx
Health Quality Ontario. (n.d.). Measuring wait times for diagnostic imaging. System performance. https://www.hqontario.ca/System-Performance/Measuring-System-Performance/Measuring-Wait-Times-for-Diagnostic-Imaging
Hofmann, B., Brandsaeter, I. Ø., & Kjelle, E. (2023). Variations in wait times for imaging services: a register-based study of self-reported wait times for specific examinations in Norway. BMC Health Services Research, 23(1), 1–9. https://doi.org/10.1186/s12913-023-10284-2
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