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AHS Needs to Improve Processes to Meet Target Wait Times for CT and MRI Exams

Report of the Auditor General—April 2021
 

Alberta’s Auditor General presented the results of his examination on the intake and scheduling processes Alberta Health Services (AHS) uses for publicly funded outpatient CT and MRI Services to the Members of the Legislative Assembly on April 22, 2012.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) exams are essential diagnostic tools used for identifying and monitoring many different diseases and ailments. When deemed medically necessary, it is important for a patient’s care that they receive these exams within a targeted timeframe based on the level of urgency.

“Waiting for medically necessary care can have consequences for patients—our partners, our parents, our grandparents, and our children—and those who care for them, no matter where we live in Alberta,” said Auditor General Doug Wylie. “This has the potential to affect all Albertans, so it is important AHS has effective processes to provide either a CT or MRI exam within the associated AHS wait time target.”

In the report, Use of Publicly Funded CT and MRI Services, the Auditor General found:

  • Intake and scheduling processes are highly manual and decentralized by geographic zone.
  • Primary Care and non-AHS clinicians, who submit the majority of outpatient CT and MRI referrals, do not have access to an integrated electronic order entry system with built-in Clinical Decision Support tools.
  • AHS prioritization guidelines are not applied consistently across the province and AHS has not developed province-wide protocoling guidelines.
  • Wait time targets are exceeded, wait times vary across the zones and they are growing.
  • AHS does not use wait times or demand as a primary factor when allocating exam budgets to the zones.
  • Impact of additional funding allocated to reduce Urgent and Semi-Urgent wait times was not sustainable.
  • AHS has the machine capacity to perform more exams.

Wylie said the audit also found that AHS has most of the data and reporting capabilities it needs, but its performance management system for diagnostics needs to be improved.

“If AHS does not use performance information regularly for continuous improvement, it is missing out on a valuable tool that could assist in identifying areas for improvement and promoting best practices,” Wylie said.

Report highights
The report includes three recommendations aimed at improving the processes and the system itself that can offer a sustainable solution, hence improving timely access for all Albertans to these important medical diagnostic services.
 

Wylie said AHS cannot implement some of these improvements unilaterally, and recommends Alberta Health work with AHS and stakeholders to assist both Primary Care and non-AHS clinicians in ordering CT and MRI exams.

“Notwithstanding our recommendations for improvement, it is important to note that Albertans successfully undergo CT and MRI exams every day, and the findings of our report do not suggest that people receiving these diagnostic services are not receiving quality healthcare as coordinated by physicians and medical professionals,” Wylie said.

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