Innovative surgical projects show how waitlists can be solved: Submission to B.C. 'conversation on health'

News release

VANCOUVER - Surgical waitlists can be dramatically cut if the B.C. government takes leadership by scaling up innovative projects already underway in the public system, a new study says.

Why Wait? Public Solutions to Cure Surgical Waitlists, released today by the Canadian Centre for Policy Alternatives (CCPA) and the BC Health Coalition (BCHC), is a submission to the B.C. government's 'conversation on health'. The study looks at five groundbreaking projects in B.C., and successful initiatives in Alberta, Saskatchewan and Ontario.

The projects reveal two key changes that will cut wait times if the B.C. government implements them at a province-wide level:

  • Team-based care: Surgeons moved from working mainly on their own to working in teams in specialized clinics. Patients are better prepared for surgeries, operations are less likely to be cancelled, operating rooms function more efficiently and hospital stays are shorter. These projects also make greater use of nurses and other health care workers at every stage of the process.
  • Pro-active waitlist management: Shifting responsibility for managing waitlists from individual surgeons to health authorities means patients can access the first available surgeon. (People who want to choose their surgeon still can). Health authorities in turn can make sure efficiencies and best practices from individual hospitals are applied across the system. Such strategies are used successfully by provincial governments in Saskatchewan and Ontario.

The Joint Replacement Access Project at Lions Gate Hospital reduced median wait times for first surgical consult from almost a year to just four weeks, and reduced wait times for surgery from as long as two years to six months.

"Without any additional resources we created an innovative model to realign and improve patient care and access," says Dawn Stangl, Manager of Surgical Access for the Coastal Health Service Delivery Area. "This new model of care was collaboratively developed with the key support of physicians, healthcare providers and administrative leaders."

Chantel Canessa, an Orthopedic Nurse Clinician with the project, emphasizes the importance of listening to patients. "Feedback received from patient focus groups was used as a roadmap for system redesign. We've already taken the lessons learned at the joint clinic and are applying them in our Rapid Access Spine Clinic."

Cindy Roberts, who co-led Richmond Hospital's Hip and Knee Reconstruction Project, says, "The strides we have made are quite remarkable, given the increased demand for hip and knee joint replacement service. We reduced median wait times for completed hip and knee joint surgery from nineteen months to under six months. Another significant outcome of the project is the practical 'tool kit' we have shared with other hospitals in B.C., enabling them to learn from the work undertaken at Richmond."

The Saskatchewan Surgical Care Network, Canada's first province-wide surgical patient registry, has used pro-active strategies to reduce wait times. "Accurate data is essential for creating management strategies and targeting resources for achieving long term success in wait list management," says network Chair, Dr. Rob Weiler. The network doesn't just report waitlists - regional health authorities are expected to actively manage them in partnership with surgeons.

"The B.C. government launched its 'conversation on health' by saying it has no choice but to consider private options," says report co-author Alicia Priest. "But these initiatives prove there are low-cost, public solutions to long waits for surgery. We should be shouting from the rooftops about them. Their success is outstanding, as is the excitement and dedication of their clinical and administrative leaders."

"There are innovative public solutions available to us right now," says co-author Marcy Cohen. "Scaling them up to a province-wide level will require a lot of collaboration and some major cultural shifts in how our surgical system functions. Allowing more private clinics will make those changes difficult - if not impossible."

"We don't hear a lot of good news about the health care system," says co-author Dr. Michael Rachlis. "But there are plenty of reasons to be optimistic. There's this myth out there that only the private sector can innovate, but this study shows that is false."

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(News Release from the Canadian Centre for Policy Alternatives and the BC Health Coalition.)

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