title: The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).
abstract: BACKGROUND
  Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy.
  
  
  METHODS
  Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes.
  
  
  RESULTS
  Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable meeting achieved its purpose (to engage stakeholders, elicit feedback, refine policy directions). Third, our decision-maker partners' expectations of the policy roundtable meeting were exceeded; they re-affirmed its value and described the refined policy directions as foundational to establishing the vocabulary, vision and framework for improving access to scheduled clinical services in Manitoba. Finally, our adaptation of key design elements was conducive to discussion of issues surrounding access to care.
  
  
  CONCLUSIONS
  Our policy roundtable process was an effective tool for acquiring broad input from stakeholders, refining policy directions and forming the necessary consensus starting points to move towards evidence-informed policy.
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
authors.forename: Zaheed
authors.initials: Z
authors.lastname: Damani
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
authors.forename: Gail
authors.initials: G
authors.lastname: MacKean
authors.affiliation: Department of Surgery, University of Manitoba, AE101 - 820 Sherbrook Street, Winnipeg, MB, R3T 2N2, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Bohm
authors.affiliation: Manitoba Health, Healthy Living and Seniors, Acute, Tertiary and Specialty Care/Regional Policy and Programs, 2061- 300 Carlton Street, Winnipeg, MB, R3B 3M9, Canada.
authors.forename: Brie
authors.initials: B
authors.lastname: DeMone
authors.affiliation: Winnipeg Regional Health Authority, 4th Floor - 650 Main Street, Winnipeg, MB, R3B 1E2, Canada.
authors.forename: Brock
authors.initials: B
authors.lastname: Wright
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
authors.forename: Tom
authors.initials: T
authors.lastname: Noseworthy
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
authors.forename: Jayna
authors.initials: J
authors.lastname: Holroyd-Leduc
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. damarsha@ucalgary.ca.|Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, 3C56, Health Research Innovation Center (HRIC) Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. damarsha@ucalgary.ca.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Marshall
mesh_terms: D019643:Arthroplasty, Replacement; D003142:Communication; D032921:Consensus; D055317:Evidence-Based Practice; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008350:Manitoba; D011050:Policy Making
keywords: Access; Deliberative dialogue; Evidence-informed decision making; Health policy; Health systems; Healthcare decision making; Knowledge translation; Public participation; Research evidence; Surgical procedures