The British Columbia government is launching a new, four-part surgical strategy aimed at reducing wait times for the health care British Columbians need.
One of the first components of the strategy will see five hip and knee replacement programs implemented throughout the province, Premier John Horgan announced today.
“For far too long, far too many British Columbians were left on waitlists instead of getting fast access to the surgery they needed to enjoy full, active, lives,” said Premier Horgan. “We’re getting people back on their feet faster by dramatically increasing access to hip and knee surgeries.”
These programs will address the long waits faced by people. In 2016-17, 30% of people waiting for hip surgery and 38% of people waiting for knee surgery waited more than 26 weeks.
“We are embedding the innovations of the former Richmond Hip and Knee Reconstruction project into our program because it is a public health-care system solution that is proven to work for patients,” said Health Minister Adrian Dix. “Our strategy will not only mean people spend less time waiting for hip and knee replacements, but that we keep up to demand for all surgeries by investing in more surgeries and implementing operating room efficiencies.”
The strategy is supported with ongoing targeted funding of $75 million starting in 2018-19 and increasing to $100 million in 2019-20.
The hip and knee replacement programs are designed to support increased surgical volumes, reduce wait times, and improve continuity of care for patients by co-ordinating all the services a patient requires to prepare for, undergo, and recover from surgery. They build on the Richmond project by adding new components like dedicated operating room time, pre- and post-surgical support, centralized intake, standardized assessment, first available surgeon and ongoing evaluation.
“We are thrilled to be part of this important work and announce the new hip and knee replacement centre at Vancouver General Hospital,” said Dr. Bassam Masri, Vancouver Coastal Health’s surgeon-in-chief for Vancouver Acute and the head of the orthopedics department. “Streamlining the intake and assessment process for hip and knee replacement surgery reduces wait times for patients, providing them with comprehensive, wrap-around care before and after surgery so they can get back to living their lives in the best way possible. With people spending less time in hospital, we are able to perform more surgeries.”
In 2016-17, approximately 14,390 hip and knee surgeries were performed, and by 2018-19, more than 19,250 will be done annually. The additional surgeries will mean a 34% increase in hip and knee surgeries. This will significantly reduce the number of patients waiting.
West Vancouver resident Christopher Hebb had both of his hips replaced at Vancouver General Hospital. “My recovery from the surgery was rapid, and let me continue to travel for work and remain active,” said Hebb. “I hike two to three times a week with my wife and, last year, I took on the Grouse Grind for the first time since my surgeries. I plan to do it again this summer.”
In total under the surgical strategy, 9,400 more surgeries – 4,000 additional hip and knee, 900 dental and 4,500 other surgeries – will be done throughout the province by the end of March 2019, compared to the previous year.
The surgical strategy has four areas of focus:
- Providing more surgeries in areas with long wait times, starting with hip and knee surgeries and incrementally tackling other surgeries with long waits;
- Investing to keep up with growing demand for all other surgeries;
- Making surgical programs and operating rooms in the province more efficient through better planning and scheduling and, establishing centralized booking and a single point of contact for patients; and
- Making sure the right number of health professionals is in place to deliver the services needed to meet demand both now and into the future, including surgeons and anesthetists, as well as nursing and rehabilitation health professionals.
Two backgrounders follow.
Sage AaronCommunications Director
Office of the Premier
Ministry of HealthCommunications
250 952-1887 (media line)
Increasing access to surgeries is being achieved through a four-part strategy, which includes performing additional surgeries, focusing on high-priority backlogs, creating operating room efficiencies and system improvements throughout the province.
1. Addressing backlogs and long waits to catch up to demand:
- Surgeries with the longest wait times and waitlists will be targeted one at a time, starting with hip and knee replacements. There will also be a focus on expanding access to dental surgery.
- Once caught up with hip and knee replacements and dental surgeries, the next set of priority surgeries will be determined.
- To support this, B.C. is establishing new hip and knee replacement programs. The first five open this year — one in each health authority. Dedicated operating room time for dental surgeries will also be added.
2. Perform additional surgeries to keep up to demand:
- 4,500 additional scheduled surgeries will also be performed, to make sure that for all other surgeries, both scheduled and unscheduled, there is no deterioration in volumes or wait times.
3. Make system improvements to create more surgical access throughout the province:
- Optimize the use of provincial operating room capacity.
- Create capacity for additional surgeries by making surgical services run more efficiently – ensuring that the first case of the day starts on time, reducing the time to get the room ready for the next patient, minimizing early finishes and reducing seasonal slowdowns of surgical services.
- Expand work underway at 11 sites to implement health authority scheduling of surgeries with patients prioritized based on need, providing patients with a single point of contact, offering first available surgeon and active surgical wait list, management and improved scheduling at a further 18 high-volume surgical sites.
4. Support for existing and new staff:
- Success of the surgical strategy is in part dependent on having the necessary health human resources available to provide services, by way of interdisciplinary team-based care.
- The ministry has conducted a provincial health human resource review and identified several professions needed to support the government’s surgical strategy, including: anesthesia, specialty nursing, physiotherapy, occupational therapy and perfusion.
- Provide regular and ongoing education, training, and recruitment and retention activities to ensure the province has the necessary health human resources in place to achieve the announced surgical targets.
- Ongoing reporting and evaluation to meet targets.
Comparing the Richmond Hip and Knee Reconstruction Project vs. new provincial hip and knee replacement program
September 2004–10: Attributes of the former Richmond Hip and Knee Reconstruction Project:
- Swing operating rooms
- Bed mapping
- Operating room scheduling and allocation
- Standardization processes, equipment, devices, and staff roles
- Monitoring waitlist management
- Measuring operating room efficiencies
- Tracking patient outcomes
- Improved patient education
Starting January 2018: Additional attributes of the provincial hip and knee replacement program strategy, building on the success of the Richmond Project:
- Dedicated operating rooms for surgical procedures
- Transfers of surgical patients between sites to prevent delays if possible
- Comprehensive data analysis and evaluation for operating room efficiencies and waitlist management
- Surgical optimization and supports to improve patient outcomes
Central intake, assessment and triage:
- Single point of access
- Standardized referral and assessment
- Appropriate redirection to non-surgical services
- First available surgeon
- Post-surgical nursing services
- Support services, community resources, and information
Interdisciplinary team-based care:
- Team of providers from both acute and primary care
Integration and co-ordination:
- Timely access to surgical expertise
- Co-ordinated care and patient communication
- Active primary and community care involvement