RESEARCH ARTICLE 1 GROUP F

ARTICLE REVIEW of MANAGEMENT SCIENCE

Public views on a wait time management initiative: a matter communication

Wait times have been ranked as a very important failing of public health systems. Waiting for care also can cause patient suffer, strained doctor patient relationships and frequently will cause patient disappointment. Many countries have tried to cut waiting times for health care through formal wait time reduction strategies. This research paper describes views of the public about a wait time management initiative-Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increase public involvement in wait time management and increased communication. Canadas Federal Advisor on Wait Times proposed that the government should disseminate information about actions provinces.

The Ontario Wait Time Strategy (OWTS) plan to improve access and reduce wait times in five areas. To describe the priority setting process of the OTWS we used qualitative case study methods. There were two sources of data, first are over 25 documents and second is 28 one to one interview with informants. Data was analyzed using a modified thematic technique in three phases which are open coding, axial coding and evaluation. The OWTS partially met the four conditions of accountability for reasonableness.

These company use two qualitative studies; an analysis of emails sent by the public to the OWTS email address and in-depth interviews with member of the Ontario public. Each of the
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methods, Ontario has five steps to complete the process: setting, subject sampling, data collection, data analysis and research ethics. For setting process, is guided by the federal selection of the five wait time areas, the OWTS decided to specifically target: cancer surgery, cardiac revascularization procedures, cataract surgery, and total joint hip and knee replacements. The OWTS launched a public website and the website provided two portals: public and

RESEARCH ARTICLE 2 GROUP F

healthcare provider. The public website reported on the actions and provided general information on wait times. All emails will send to the email address on the OWTS website. The data collection find out that, Otario received 116 emails, two of which were duplicates and in total 114 emails were analyzed. The data analysis is process in three phases: open, axial and selective coding. For addressed the validity of the interpretations in three ways. Firstly, two researches coded the raw, second the emerging finding was presented to an interdisciplinary team for questioning and finally, rigorous record of data analysis and methodology was documented by the researcher. Research ethics of this method approval granted from the Sunnybrook Health Sciences Centre and University of Toronto Research Ethics Board. A confidentiality agreement, written by the Ministry of Health and Long-Term Care, was binding to the researchers.

The second methods is locates in downtown Toronto, Canada. For interview method, Ontario uses two sampling methods: convenience and snowball sampling. Participants were eligible if they were residents of Ontario, over ages of 18 and able to participate in a 20 minutes interview in English. Healthcare workers, employees or directors of pharmaceutical companies and members of provincial parliament or other elected officials were excluded from study participation. Participants were recruited at the Family Practice Unit in two ways: in-person, real time, recruitment in the clinics waiting room area, and posters and information sheets displayed in the clinics waiting room area. Total of 34 individuals were recruited.

Recruited
Study posters 12% Referal by a previous participant 3%

In person recruitments 85%

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RESEARCH ARTICLE 3 GROUP F

The interview was audio taped and transcribed. Then, the data analysis and methods of addressing the validity of the interpretation were the same as the analysis of emails. Lastly, research approval was granted from Board and the University of Toronto Health Sciences Research Ethics Board. All data and participation were kept strictly confidential and available exclusively to the research team.

Results of the analysis of emails and interviews find out that only emails correspondents supported for the OWTS and they suggested wait time reduction effort would improve the health system. Sadly, email correspondents were dissatisfied with the communication efforts of the OWTS and wanted more communication with the information. Moreover, the analysis find out that have the emails respondents doubted the legitimacy of information disseminated by the OWTS on its website and through the media was inaccurate, misleading and even dishonest. They desire for truthful information, even if it was discouraging. Ten email correspondents sent emails addressing a lack of response from the OWTS to their previous email. In addition, certain respondent those who received a generic form-letter perceived it as insincere. Some email correspondents who were aware of these efforts were angered by the OWTS television advertisements and suggested the advertisements were a waste of money. The OWTS needs to reconcile this dichotomy. The OWTS website clearly stated that the OWTSs definition of wait time was the time from the decision that surgery was indicated to the time of surgery, and did not claim to incorporate the time waited to see a general practitioner and a specialist. However, many participants in our study distrusted the OWTS website because this definition did not correspond with their experience of waiting for care. Consequently, participants believed the wait time statistics were conceptually flawed. The public were not well enough informed of the activities of the
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OWTS. To facilitate effective public involvement, participants suggested the OWTS needs to communicate more information to the public about the Strategy. The public should be informed of the Strategys activities and relevant issues prior to decisionmaking.

RESEARCH ARTICLE 4 GROUP F

From this research,we suggest the Ontario use Share Decision Making, means cooperation between the public involvement and experts will give good result and fairness at all stages of OWTS decision making. All stages of people are included in decide decision for Otario and the results of this will make all people satisfied. Remember that, customer is always right and should fulfill their satisfaction for their happiness. They happy and we will happy too. Other than that, we can improve Communication Strategy where public involvement and experts will always communicate each other using the appropriate system. Result from this, Otario will have two ways communications and it is easy to disseminate the actions have been taken by Otario in among the public. Otario should give fullest information about the strategy into the website or portal and give details explanation about the current wait time statistic. Besides, Otario should advertise year to year statistics and new information about the wait time strategy via internet, radio, and television. From that, all public will understand clearly and not make any negative statements. Lastly, we suggest that Otario should have Feedback Mechanism that help Otario know new information directly from public. Otario should have a space for questionnaire in the website that will fill in by the users. From this Otario will get day to day result by view the statistic answer. We think that this analysis should include staff of this company because; all staff has their rights as citizen of Otarion also. Why not, do the research by interview to all staff.

Hopefully, our suggestion helping for Otario make improvement in waiting time strategy.

April 28, 2011