The results of the analysis of emails and the patient interviews are presented separately. Direct quotations are provided to illustrate the results. To avoid identifying specific individuals the participants have been allocated identification codes.
Analysis of emails
Support for the Initiative
Five (of 116) email correspondents expressed support for the OWTS and described the OWTS as a worthwhile initiative because they believed that Ontarians are generally waiting too long for care. They suggested wait time reduction efforts would improve the health system.
I do believe in the wait time project and applaud this initiative... it can only improve health care. (Lay Public, 1)
Disappointment with the OWTS Communication Strategy
Overwhelmingly, email correspondents were dissatisfied with the communication efforts of the OWTS, specifically the OWTS's response to their emails and the information available on the OWTS website. Email correspondents wanted more communication with and information from the OWTS - they wanted to use the website as a vehicle to engage with the OWTS about the Strategy. As well, email correspondents doubted the legitimacy of information disseminated by the OWTS.
OWTS Responses
Ten email correspondents sent emails addressing a lack of response from the OWTS to their previous email(s). In addition, those who received a generic form-letter perceived it as insincere, and they expressed anger over the lack of a personalized response addressing their particular issue. Email correspondents wanted to be able to use the OWTS email address as a method to engage with the OWTS about their questions and concerns, but their emails were either not acknowledged or acknowledged only generically.
What must be done to get you people to reply to e-mails that are sent to you? This is my third follow-up to my original message!! You should remove the capacity for persons to contact you by e-mail if, as appears to be the case, your policy is just to ignore e-mail messages that people send you. (Lay Public, 2)
The OWTS website
Twenty four email correspondents requested additional information beyond what was offered on the OWTS website. Examples of information requests included clarification of information, directions for how to move from a current wait list to a shorter wait list, and requests for wait time statistics not available on the website.
What are my next steps to get an MRI in a reasonable time frame - not 224 days that is current wait list in Kitchener, Ontario? (Lay Public, 3)
Distrust of OWTS Information
Wait Time Statistics
Sixty-two email correspondents shared angry sentiments about the Strategy's wait time statistics. They believed that statistics disseminated to the public via newspapers, the television, and the website were false. They articulated a desire for truthful information, even if it was discouraging.
I was told he would book the [cataract] surgery but was already booking into March/07. This does not line up with the stories in the local papers that wait time for cataract surgery is 128 days. How can anyone believe anything they are told or read? I believe the Ministry is not being honest about wait times ...Why is the reality so different than the government's stories about shortened wait times? (Lay Public, 4)
Television Advertisements
Seventeen email correspondents shared angry sentiments about the OWTS television advertisements. They asserted the advertisements were a waste of resources and misleading to the public - they gave a message that all wait times were being reduced, when only five areas of care were being targeted. It was suggested the resources spent on the commercials should be spent directly on wait time reduction efforts.
I find your recent TV commercial for wait times very misleading and as such, if I were you, I'd be very embarrassed to even put it out there. You give the impression that the wait times for ALL doctors have decreased, which is NOT the cases whatsoever....As a Ontarian I am quite embarrassed to see those ads and feel you should remove them immediately and put some TRUTH in those ads before running them again. (Health Care Worker)
Wait Time Definition
Twelve email correspondents claimed that the definition of wait times is misleading and contributes to the deceitfulness of the wait time statistics as it does not account for the time waited to see a general practitioner or a specialist.
I have found that the wait time statistics are flawed! ...This may be correct if only counting the time a person has to wait from the time he/she sees the surgeon to schedule surgery and the time surgery is performed.... In other words your statistics are flawed and give an incorrect picture of health care in Ontario. (Lay Public, 5)
Part Two - Interview Findings
Participants' Views on Public Involvement in the OWTS
All 34 interviewees strongly supported public involvement in the OWTS priority setting, describing it as a necessary component of decision making.
I think anything to do with the Government -- [for instance] when it comes to introducing more funding, more staff into the healthcare system -- I think the public should always be involved. (Male Patient, A)
Most interviewees suggested that members of the public can offer insight into the lived experience of being ill and using the health system. Such a perspective cannot be offered by 'experts' and is relevant to priority setting.
We're the ones that experience the healthcare system. To me, the politicians are sitting behind a desk. They're not sitting in emergency waiting. They're not sitting with their dying parent. Now, I'm sure they've had those experiences, but I think the public in general should be in on making decisions as to how our healthcare system goes. (Female Patient, A)
According to participants, members of the public can best identify the needs of the community.
Well, it's the public that's experiencing wait times. If there isn't any input from the public, like in business if there isn't any input from the customer, how do you really identify what the needs are? (Male Patient with Chronic Health Condition, B)
Enhanced 'Buy-in'
Seven participants proposed that the public will be more likely to buy into the initiative and support the actions and priority setting decisions of the initiative if they are involved.
Because then you get buy-in with the whole process. I think [public involvement] would help [the OWTS] because [the public] are not feeling that they have any control over the health system. You just don't feel like you're part of it, and if you're not part of it you're against it. Like if having the public come in and at least getting their opinion, then you get some sort of buy-in. (Female Patient with Chronic Health Condition, B)
Shared Decision Making
Seventeen participants supported shared decision making between experts and the public. They described an auxiliary role for the public in priority setting decision making - the public should collaborate with experts in the decision making process.
So it would be nice if the Government before spending money could talk about their plans for the public, so the public can share their decision with them. (Male Patient, A)
Disappointment with the OWTS Communication Strategy
Interview participants did not feel they were sufficiently made aware of the OWTS or its' actions. Less than half of the group interviewed was aware of the OWTS (47%); most became aware of the Strategy via the radio or television. Less than one fifth (15%) of those interviewed were familiar with the details of the Strategy (e.g. Which health care areas were prioritized by the Strategy? What efforts the province had taken to reduce wait times?). Only one interview participant was aware of the OWTS website.
Eleven participants expressed concern that the public were not well enough informed of the activities of the OWTS. To facilitate effective public involvement, participants suggested the OWTS needs to communicate more information to the public about the Strategy. The public should be informed of the Strategy's activities and relevant issues prior to decision-making.
They aren't communicating very well with the public for us to be informed to make decisions anyways. If we don't have ...information [about the OWTS], then we can't truly make a decision as a public whole what our needs are. I just find, they communicate what they want us to hear. (Female Patient, C)
Two participants suggested lack of communication about the OWTS to the public can lead the public to misinterpret the purpose of the strategy.
I think there's a whole lot of, I don't know if it's misinformation, but people should be able to inform themselves or someone should inform them what [the OWTS is] all about. ...it's just a matter of education. (Male Patient, C)
Two participants proposed that if the public were given more information on wait times they would be more willing to wait for care, as long as the wait time is within medically acceptable standards.
I do think that if the person is knowledgeable about the risk of waiting, and that would be important to communicate that to the public -- because I don't mind waiting six months if I know it is for a routine test.....I am trusting the government to know that that is an acceptable standard. (Male Patient, D)