Addressing wait times and the backlog

Ontario’s doctors are calling for the creation of Integrated Ambulatory Centres.

The need to address the surgical backlog is urgent. Ontarians’ health is deteriorating due to a significant backlog of surgeries and procedures built up during the pandemic.  

In a proposal for the Ontario government, Integrated Ambulatory Centres: A Three-Stage Approach to Addressing Ontario’s Critical Surgical and Procedural Wait Times, the OMA is calling for immediate attention to eliminate the pandemic backlog of health-care services and the creation of a new model of care called Integrated Ambulatory Centres.

Integrated Ambulatory Centres

Integrated Ambulatory Centres would safely provide additional lower-complexity procedures and surgeries typically provided in hospitals in community settings. Patients could safely receive more day surgeries and procedures typically provided in hospitals in Integrated Ambulatory Centres, enhancing hospitals’ capacity to deliver more care requiring a hospital setting. Shifting appropriate day surgeries and procedures to Integrated Ambulatory Centres could improve the experience for patients by providing faster access to surgeries and procedures, lower infection rates, while providing anticipated efficiency gains of approximately 20 to 30 per cent.

Integrated Ambulatory Centres represent the most significant ambulatory care modernization in more than three decades since the creation of independent health facilities. To ensure integration with the overall health-care system, these proposed centres would work in close partnership with, or be part of, local hospitals.

A new model of care

Integrated Ambulatory Centres: A Three-Stage Approach to Addressing Ontario’s Critical Surgical and Procedural Wait Times calls for immediate attention to eliminate the pandemic backlog of health-care services and the creation of a new model of care called Integrated Ambulatory Centres.

Read the executive summary.

Read the full proposal

Proposed timeline

For the current system to evolve into this integrated future state, the proposed model outlines three stages that span five to eight years, each designed with system stability in mind.

Stage 1: Expand capacity (2022-23)

  • Continue expanding and leveraging existing capacity in the system to reduce the backlog of surgeries and medical procedures
  • Provide targeted funding with clear ties to increased volumes and high priority areas
  • Test new partnerships between relevant independent health facilities and hospitals

Stage 2: Launch Integrated Ambulatory Centres (2023-25)

  • Introduce new legislation to create a fit-for-purpose quality and safety framework for new Integrated Ambulatory Centres
  • Establish single-intake systems for surgeries and procedures to improve faster access to care while maintaining patient choice

Stage 3: Faster access to care (2026-2030)

  • Integrated Ambulatory Centres are established and continue to expand
  • Relevant independent health facilities will transition to Integrated Ambulatory Centres in a phased manner
  • Ontario’s five health regions and Ontario Health Teams deliver care that integrates ambulatory care with primary care, rehab, home and community care

To develop these recommendations, the OMA commissioned Santis Health to lead consultations with key system stakeholders.