Box 1 Five policy directions (with overview) that were presented for discussion at our policy roundtable meeting

1. The quality of health service delivery should be measured and monitored according to a provincial framework

This was presented as the first policy direction as it is foundational for the successful establishment of a single-entry model (SEM). The impetus for the establishment and success of the Winnipeg Central Intake Service stems from the grounding of its processes in data, enabling the rigorous tracking and monitoring of patient referrals and data related to health service delivery and outcomes. Along with established guidelines for data collection, it is necessary for data to be monitored according to agreed-upon criteria that would be consistent across the province.

2. Central intake should be the preferred model for service delivery of scheduled clinical services

With considerations for data collection, management and privacy in place, SEMs represent a strong alternative to traditional models of patient management. SEMs are especially well suited to choice-sensitive, elective scheduled procedures. This policy direction served to position centralised intake as the preferred model for management of patients awaiting scheduled services.

3. Central intake programs for scheduled clinical services should be provincial, where appropriate

With common guidelines and processes in place, resources can more efficiently be shared across the province – whether personnel capacity, operating room time or other resources – for both patient and system-level benefits. This can also allow for access based on patient preference and proximity, while harnessing provincial capacity to the fullest extent possible.

4. Central intake structure and processes, as well as relevant performance indicators of patient and system outcomes should be made available in a transparent fashion to the public and health providers

Patients feel more at ease and less anxious when more fully informed about what can and should be anticipated as they prepare for their procedure – whether this includes the anticipated date of surgery or breadth of education classes available. As part of efforts to increase accountability, patient communication and shared decision-making, data that is being collected can and should be shared to increase patient and provider confidence in the efficacy and safety of SEMs. This reporting can also be used to strengthen health system performance and inform governance and future planning.

5. Patients should maintain the choice of seeing the first-available specialist or specialist of their choice for a scheduled service

In addition to more efficient management and expeditious access, at their core, SEMs are meant to increase rather than decrease patient choice. The hallmark of the success of SEMs is their ability to both respect patient choice – to see either a specific or next-available surgeon – while improving access.