Alberta’s Registered Nurses Position on Wait Time Guarantees
April 19, 2006

Edmonton, April 19, 2006 – The College and Association of Registered Nurses of Alberta (CARNA) participated in a roundtable discussion on wait time guarantees with Federal Minister of Health, Tony Clement today in Calgary.  CARNA’s position is that meaningful reduction in wait times will only occur if immediate action is taken to address the key access barriers, such as shortages in health care personnel, system capacity and information technology.   The focus should be on preventing illness, managing chronic diseases and establishing guidelines for appropriateness of care to reduce pressure on the system. This position is also supported by the Canadian Nurses Association.
CARNA also pointed out that a wait time guarantee for a few selected services does nothing to address the underlying problems of shortages in health care personnel or effective system management.  Directing attention and resources toward a few tertiary-level health services can pull resources away from other areas, thereby worsening access to an unknown range of needed health services, including prevention, promotion, primary care and community support services.  As well, implementing guarantees would require a complex administrative system for monitoring compliance and establishing which criteria for the guarantee.   Alberta’s registered nurses offered the following recommendations to address the issue of care guarantees for health services: 

  • Focus urgent attention, at all levels of government, on addressing the crisis in health human resources.
  • Use standardized measures to assess priority so that the next patient to receive a service is the one with the greatest need and apply these measures equally, regardless of who is paying for the services.
  • Include measures of appropriateness, so that only those patients for whom the degree of expected benefit exceeds the risk and cost will be eligible for the service, regardless of who is paying.
  • Establish nationally agreed-upon targets and benchmarks for acceptable wait times for a full range of health services, based on best clinical outcomes.
  • Confirm reciprocal relationships with other jurisdictions so that, for life-threatening conditions or highly time-dependent interventions for which local capacity is insufficient,  there is timely arrangement for acquiring and funding service for patients whose wait will exceed the benchmark. 
  • Support the work towards common definitions and data collection methods.
  • Ensure ongoing development of reliable, standardized instruments for assigning clinical priority/urgency ratings for specific health services.   Implementation should be connected to centralized regional or provincial processes for booking services.
  • Streamline processes and eliminate unnecessary waiting at each step in the care continuum, e.g. Alberta Hip and Knee project.

CARNA is the regulatory college and professional association for Alberta’s more than 28,000 registered nurses, the largest health profession in the province. Its members include registered nurses and nurse practitioners working in direct care, nursing management, education and research. CARNA sets nursing practice standards and ensures Albertans receive safe, competent and ethical nursing services.

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