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Box 2 Policy direction participant group discussion summary

From: The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS)

Policy Direction #1: The quality of health service delivered should be measured and monitored according to a provincial framework
There was enthusiasm and a consensus feeling among attendees that the concept of ‘measurement’ and ‘monitoring’ is critical to moving forward with a centralised intake and that this particular policy direction is foundational to the others.
Policy Direction #2: Central intake should be the preferred model for service delivery of scheduled clinical services
Participants agreed that, while suited to choice-sensitive elective procedures, single-entry models are not universally applicable, needed or possible across all clinical services in all regions/jurisdictions.
Policy Direction #3: Central intake programs for scheduled clinical services should be provincial, where appropriate
There was a realisation that centralised intake is part of a larger system, part of a continuum, but does not constitute the whole system. It would, however, serve as an opportunity for system level improvements, whereby it results in providers working collaboratively to provide quality care.
Policy Direction #4: Processes for central intake and performance indicators for patient and system outcomes should be made transparent to the public and to providers
There was agreement that a provincial single-entry model can facilitate improved access (via better tracking, measuring and monitoring) and better sharing of resources for everybody in the province. Where in use, a provincial model should be governed by provincial standards for quality (to ensure transparency) and allow resources to flow across regions. Careful thought needs to be given as to what should be reported and how well it could be understood. Increased transparency could mean increased accountability and put pressure on the system for continual improvement. Such reporting can also provide assurance to patients that processes are in place to ensure high quality of care standards.
Policy Direction #5: Patients should maintain the choice of seeing the first-available specialist or specialist of their choice for a scheduled service
There was strong consensus that patients must be able to maintain their choice. Patients have varying degrees to which they seek advice and support in their decision-making. With measuring and monitoring in place, confidence can be increased in providers across the system so that patients can feel more confident. Patient choice is important to retain with the introduction of any central intake process for scheduled and elected surgery. Quality of care should not differ for patients who choose to see a next-available versus a specific surgeon.