Shorter Waits For Weight WiseMonday, September 26, 2011
About four years ago, when I came to Alberta to take on the role as Medical Director of the Edmonton Weight Wise Program, there was a waiting list of over 2000 patients to be seen in the adult speciality clinic at the Royal Alexandra Hospital. This waiting list was growing by about 50-100 new referrals a month, a rate far exceeding capacity to see new patients.
Since then, as long-term readers of these pages may recall, a number of important measures were implemented, that have brought down wait times from over 24 months to currently less than 6 months – a situation readily explained by the fact that patients are now moving through the program (and, if required, on to bariatric surgery) at a rate almost one-third faster, than when I first took over the program.
Thus, through a combination of changes to how patients are referred to the program, what they do while on the ‘waiting list’ and due to efficiencies and increased capacity within the program, more patients are being seen within waiting periods that are shorter than ever before.
Much of this starts with the referral process – by ensuring that family doctors refer only patients, who do not have obvious barriers to participating in a speciality care bariatric program (like for e.g. complex and uncontrolled mental health problems), resources within the program were freed to deal with patients who can actually be helped at a bariatric centre.
Offering patients ‘education modules’ in the community setting prior to entering the program also resulted in patients being better informed and prepared by the time they were seen at the speciality centre, thereby significantly cutting times spent within the clinic.
Once patients enter the specialty clinic, a designated nurse case-manager ensures that they see the appropriate allied health professionals (dieticians, psychologists, occupational and physiotherapists, etc.) at the right time for the right level of intervention. Where possible, delivering counselling in group settings rather than one-on-one further increases efficiencies and takes advantage of the substantial benefits of ‘group learning’.
Finally, increased medical and surgical capacity has further shortened waiting times for patients approved for surgery within the program (down to a few weeks from previously several months).
As a result of these changes, progressively implemented over the past several years, we are now thankfully in a situation where new patients referred to the Edmonton Weight Wise program can be seen in the clinic within a few short months of referral.
Obviously, once word gets around that patients are no longer faced with a two-year wait, referrals may quickly increase to once again extend waiting times. However, with the recent announcement of additional resources for community and primary care (so that more patients can be managed there or at least be better prepared for speciality care) and additional capacity in speciality centres across the province, it is very likely that more Albertans with severe obesity can receive medical, and, if necessary, surgical attention quicker than ever before.
This is obviously good news for patients, who have decided that it is high time to tackle their obesity problem as well as for their caregivers, who can now help their patients access a wider range of treatment options within a reasonable time frame.
As the recently announced Alberta Obesity Initiative continues to roll out, I certainly hope that eventually all Albertans struggling with excess weight will have access to the level of care required to help them better manage their weight and reduce associated health risks.