No further replies from Alberta Health to my questions including why they stopped publishing weekend numbers, etc. Still waiting…
Here’s the update based on the numbers they published:
Calgary Zone Covid19 TOTAL Confirmed cases:
NEW cases only to date
ACTIVE cases only to date
May 16 cont...
10:45
2nd AKIC U Calgary appointment (Finally)
.
Wait Time has been 57 days so far,
19 days behind actual scan completion
.
follow up to go over April 27 MRI results
Again, I feel reluctance to work with me, in only 2nd appointment. When I bring up ligamys doctor does not seem familiar with it and can't answer questions. I ask if he read the emails I sent with the information and am told they were not read.
.
.
I inform him the surgeon responded I may be an ideal candidate for InternalBrace and am told “We don’t do that here.” Concerned the help that could be offered on this will not be provided I said “I just need you to support which ever surgeon I end up working with by helping me get him the information he needs.” I do this to ensure consensus is established on how we’re going to proceed with expectations & responsibilities as I don’t know what may be required.
.
.
I told him I’d send the medical journal on Internal Brace to share & discuss with the surgeons so they know what I was referring to and how they can provide this option.
.
.
At this point I’m perplexed why they don’t know about this and am having some doubts about the Canadian Healthcare system.
1:46pm
I send the AKIC sportsmed doctor at U Calgary information on internal brace to share with the surgeons he had yet to tell me a name of, as I’ve lost faith they’re offering current practices however I don’t see why they wouldn’t be interested in learning practices with better patient outcomes. https://www.arthrex.com/what-surgeons-are-talking-about/131FD01B-7B44-491D-B5F7-015A9474A65E
2016 article on AHS from the Calgary Herald on MRI wait times increase in Calgary – how many of these could be understood by the work from my Aug 12 post:
Still eating fresh pineapple for bromelain, found in every part of the pineapple, but most plentiful in the stem. Seems the clot isn’t a concern anymore; pineapple enzyme is supposed to help break up existing clots and prevent future ones from forming. I usually blend it into a smoothie.
April 30, 2018
I received the following email:
“We have received your MRI results and Dr. _____ would like to see you back in the AKIC to go over those results on:
Wednesday, May 16th at 10:45am. (16 day wait time)
We are happy to report that there are no urgent surgical findings in your #knee. Please continue with rehab exercises (ie. physiotherapy, athletic therapy, or home strengthening/flexibility program) and activities as tolerated. Please remain in linear activity only (no pivoting or twisting) and no impact exercise (no running or jumping).
Please reply to this email confirming the above appointment”
To which I promptly replied:
“Are there any non-urgent surgical findings?
It really blows my mind I know 2 people who had MRI's scheduled, results provided and in 1 case surgery conducted in less than 2 weeks, and I have to wait over 2 weeks just to review them. A phone call would be great to give me an idea of what's going on.
Also wondering if I am better to have results sent to my previous sports medicine doctor in Toronto and fly their to speed receipt of diagnosis. I understand from my healthcare background this is due to the medical care system setup, not individual people. If you would like to reduce your turn around times, I would be happy to help.
As for your recommendation not to run or jump, I can barely walk.
Evening prior to MRI I stepped off a curb and bent my knee more than it wanted, and it has been quite challenging since then.
Confirming the appointment in half a month.”
The step off the curb 3 days prior brought the inflammation back to where it started.
Received call from AKIC doctor at U Calgary next day, who provided some clarification. Very grateful for this.
*even though the radiologist completed their report promptly, & the doctor received it, there’s still a 16 day wait time for results instead of scheduling them within 24 hours of actual availability. Go back 4 & 7 posts to see examples how wait times are reduced with lean healthcare in the emergency room and MRI, which can be done
Total Wait Time so far for diagnosis: 40 days
Plus the additional 16 days now.
Here's an example
HOW TO REDUCE MRI TIMES:
https://pubs.rsna.org/doi/full/10.1148/rg.347140025
This was done at Department of Diagnostic Radiology, Henry Ford Hospital,
2799 W Grand Blvd, Detroit, MI.
It is more complex than most I would expect, and the team did not quit, they followed through their learning.
I've been implementing Lean for 10 years, part of that in healthcare, if you have questions or a hospital CEO interested in leading your facility to obtain these results.
It works.
The question is are you learning how to apply it Alberta Health Services?
I receive a call saying MRI appointment is for March 2019
- 1 year away.
Cannot straighten leg or bend it near 90 degrees.
*Would be 3 weeks post op in US and recovering; being told I have to wait a year now here.
Consider that other people have families, children or their elders to take care of; or may not be in a financial situation that allows a 1 year pause due to pending injury diagnosis - 1 year is unacceptable for MRI wait times.
It can impact their quality of life, #recovery potential & ability to economically contribute or support dependents.
This situation supports unnecessary ACL amputation & ACL reconstruction when diagnosis & #treatment is not achieved within the time frame for natural ACL regrowth - more explanation to follow.
Is MRI magnet time at 100% ?
If so, are we executing Lean Healthcare reducing costs in other areas to free up the available funding to purchase new equipment like so many other hospitals?
For example, Lean has been used to improve hospital utilization, improving patient outcomes while reducing the need to add entire proposed #hospital WINGS.
When properly applied the CEO frees up $$, space & resources which can be redeployed for additional healthcare services (or MRI suites).
One way to learn a solution Alberta Health Services
- in the same way emergency wait times are consistently reduced through 3-5 day Rapid Improvement events, MRI wait times are reduced the same way.
see how it's done in next post
Thu Mar 27 - day 10
Happy to see hand washing % sign on wall in emergency Alberta Health Services; still need to start continuous improvement though.
Triage & admitting were reasonably quick; next wait room was 2 hours - at least they know the wait time - no sign of Lean Healthcare.
While waiting for knee diagnosis saw the sign (in pic) - assuming someone else has also - hoping I don't rely on it either if still in disrepair.
At least it's visual.
speak to orthopedic surgeon,
says we can do aspirin and check in about 10 days to see if things clear up, or weeks of Rivaroxaban.
Has a pager call (they still exist!) & says to look it up while he takes the call.
A quick review of its side effects and I don't see why one would take this unless absolutely necessary. There's also no reversal (as there would be warfarin/rat poison).
We talk more and are in agreement checking back in 10 days is a reasonable course of action.
He says he'll get a 2nd opinion from the hemotologist, comes back and is pro Rivaroxaban prescription.
I call it and point out how flip flop this is, & I prefer not to take the prescribed anticoagulate. We agree so I'll set up another ultrasound.
I look up natural blood thinning options and adjust my diet with daily pineapple for bromelain, tumeric, apple cider vinegar, cayene pepper, garlic, fish & sardines, lemon, green tea and natto.
....................................
noticed more painful to walk in running shoes than ski boots
Sunday March 18
- drove back to Calgary
Will be interesting navigating healthcare as a patient with my background implementing lean at 3 hospitals. Alberta is behind all the western Canadian provinces in their adoption of Lean Healthcare to improve patient outcomes.
BC started a few years before they moved me there, Saskatchewan is at the point they're using 3P, and Alberta sandwiched in between by my measure has not even started.
Going to pay particular attention to wait times.
Monday March 19
went to see my doctor who sent me for xray & ultrasound on knee - went same day - report in photo. I still think everything is ok and may be able to hit May long Sunshine village. Didn't go for the meds or crutches.
so far
88% wait time (10.75 hours) for
12% value add/service (1.5 hours).
Tuesday March 20
morning - walking is tough, actually considering crutches MRI & Acute Knee Injury Clinic appointments requested.
Wed. Mar 21
24 hours later AKIC responds to request, no appt yet.
Nothing from MRI.
*If I were in the US I would have had it yesterday and would be reviewing the results.
let's see how long it takes Alberta Health Services
............................