(file photo)

By Josh Hall

more infrastructure needed

Surgeon says province’s plan unlikely to clear Red Deer’s surgical backlog

Mar 9, 2021 | 4:26 PM

A local surgeon says it’ll be impossible to eliminate the backlog of surgical procedures at Red Deer Regional Hospital by the end of the year.

On Friday, Health Minister Tyler Shandro announced more than 55,000 additional scheduled surgeries would be completed in the upcoming year, clearing the logjam of more than 30,000 procedures delayed by the pandemic.

However, Dr. Keith Wolstenholme says that won’t happen in Red Deer.

“Before COVID hit, we were already running at 100 per cent capacity, meaning we’re using all our available operating rooms, all our time and all our beds,” he explains.

“We would routinely have elective surgeries cancelled for one of two reasons: either there was no bed to put the patient in afterwards, or there was too much trauma volume on our emergency list and we couldn’t keep up.”

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Wolstenholme says it’s a no go with operating at 25 or 50 per cent over capacity in order to eliminate the backlog, adding they may be hard pressed to clear 80 per cent of it.

Wolstenholme says the hospital in recent times has lost about 30 per cent of its anesthesiology staff. Many have retired or are eying retirement, he notes, leaving about 13 of them when there should closer to 35.

“This hospital serves 450,000 to 500,000 people. For that volume, we should have 16 to 20 operating rooms, and we should be able to fill them all with enough anesthesiologists to cover what we call ‘night call’ because the hospital doesn’t close,” he says, saying some are working 24-hour shifts every sixth day.

“We’re not going to make up time with this Alberta Surgical Initiative. We’re going to fall further in the hole.”

Shandro also said the province’s goal of reducing overall surgical wait times by 2023 to ‘clinically acceptable’ lengths. Wolstenholme feels that, too, will be tough to accomplish.

“If we look at hip or knee replacements, a patient probably waits close to two years to see a surgeon in clinic and close to two years after that to get their joint replacement,” he says. “The Canadian Institute of Health Information has said a patient waiting for a hip or knee replacement should wait no longer than a year maximum.”

Wolstenholme says the typically acceptable time limit they put on a patient’s file is three to six months.

“I’ll tell you we almost never get a patient into the operating room in under six months,” he admits.

In the end, Wolstenholme says it comes back to one problem – chronic underinvestment in Central Zone health care infrastructure.

“We are certainly worse off with a backlog of surgeries because of COVID, but this is not a new problem for Red Deer Regional Hospital and central Alberta. We’ve been running the same eight operating theatres at Red Deer for 20 years with no real expansion,” he says.

Alberta Health Services acknowledges in a statement that Albertans want and deserve more timely access to surgeries when they need them.

“We share this concern – nobody should have to wait longer than clinically recommended for their surgery. However, bringing surgical wait-times down is a complex and challenging task, particularly given Alberta’s ageing population. AHS is already making gains on the province’s surgical backlog, and we should be back to pre-pandemic surgical levels by the fall,” the statement reads.

“We expect that Central Zone surgeries will increase in number during 2021/22 fiscal year. With the increase in the current 2020/21 fiscal year, that will mean increases in the number of surgeries done in Central Zone in both years. Planning is currently under way to determine the exact numbers and types of surgeries to be done in the coming year. We expect those plans to be completed and moving forward later this spring.”

AHS says COVID-19 activity will continue to have an impact on the capacity to deliver surgery, and that there are a number of strategies underway to support the Surgical Recovery Plan. This includes resuming surgical services at AHS sites where activity needed to be slowed during the second wave of the pandemic, increasing the volume of surgeries in chartered surgical facilities already under contract with AHS, and establishing new publicly-funded contracts with existing and new Alberta vendors to expand the scope of surgeries (including orthopedic day procedures, plastics and general surgery).

AHS says it is working to ensure appropriate staffing supports are in place, including anesthesiologists., and that site-specific plans are currently under development.