1. Introduction to the Wait Times Benchmarks Project
Access to speech, language, swallowing and hearing services is a critical concern across Canada. One indicator of the urgency of the problem is lengthy waits for service after a need has been identified in one of these areas. Of course this issue is not restricted to communication health as attested by the Wait Times Alliance. The Alliance was formed by doctors in 2004 to provide solutions to the problem of long waits for medical care in Canada’s publicly funded health service. Sadly, long waits for speech, language and hearing services are not specific to Canada, as reports in Australia and the United Kingdom have highlighted similar concerns to those raised by families by of children and adults who need services in Canada.
Although access to service is a multifaceted problem there are many reasons that wait times in particular invite a common focus by clients, service providers, funders, and politicians as the essential issue to target for improvement. The recent report by the Wait Times Alliance (Time to Close the Gap, Wait Times Alliance, 2014) lists several:
- it is established that many other countries with universal health care have succeeded in providing timely access to service and therefore we should not tolerate long waits when they are clearly not necessary;
- it can be shown that long waits for necessary services impose a significant burden on patients who are waiting as well as on society in general; and
- long waits for service impair health system performance such that improvements to wait times should result in gains for the system as a whole.
These considerations are as crucial for speech, language, swallowing and hearing health as for any other sector of the health care system. One step toward improvements in wait times is the development of benchmarks that indicate the maximum time that an individual should wait for service after taking into account the likelihood of significant clinical consequences should the wait be longer. The Pan Canadian Alliance of Speech-Language Pathology and Audiology Organizations has committed to establishing reasonable wait times benchmarks as the first step toward reducing wait times for services. A series of ad hoc committees recommended benchmark wait times for different diagnostic categories (see the Speech-Language and Audiology Canada (SAC) website). These wait times are being reviewed and reformatted according to a standard template and released publicly to the clinical community one at a time along with a published paper that provides the scientific foundation for each benchmark. The Benchmark Wait Times for Pediatric Speech Sound Disorders was released at the SAC Conference in May 2014 _and the associated Report was published in CJSLPA in Spring 2014 .The revised Benchmarks for Pediatric Language Disorders will be released soon and the Benchmarks for Fluency disorders are in progress.
In addition to releasing the benchmarks and the associated scientific reports, SAC will be providing additional information about benchmarks and their use in this blog which will be cross-posted to the SAC website and developmentalphonologicaldisorders.wordpress.ca. We will be inviting feedback and participation from the SAC membership or other interested commenters with each release. The schedule of upcoming blogs is shown below. We hope that you will follow the blog and consider commenting or contributing to this conversation.
2. What is a Benchmark?
3. Approaches to Developing Wait Times Benchmarks
4. Evidence Based but not Evidence Bound
5. Use of Benchmarks by Clinicians and Policy Makers
6. Potential Advantages of Having Wait Times Benchmarks
7. Potential Disadvantages of Having Wait Times Benchmarks
8. Strategies for Achieving Wait Times Benchmarks
9. Factors that Impact on the Achievement of Wait Times Benchmarks
10. Role of the Pan Canadian Alliance and SAC in the Achievement of Wait Times Benchmarks