Long wait for surgery nears end for 96 Horizon patients after staff volunteer to work OT

About 96 New Brunswickers who have been waiting up to a year for hip and knee replacements will soon see relief, thanks to a weekend surgery pilot launched Thursday by the Horizon Health Network.

Surgical teams in Fredericton, Miramichi, Moncton and Saint John have volunteered to work overtime on Saturdays between November and February to complete a "blitz" of primarily orthopedic surgeries, starting with patients who have been waiting the longest, said interim president and CEO Margaret Melanson.

"This initiative is an innovative and efficient way to continue to address our systemic challenges and barriers to providing access to surgery," she said.

The additional surgeries are not expected to take away from any other strained health-care services, such as emergency departments, Melanson told reporters during a briefing held via Zoom.

She commended the surgeons, surgical nurses and anesthesiologists who have stepped up. They are "very conscious of the waiting list and wait times that we're facing and willing to do their part to assist with this intense effort," she said.

It's "about improving the lives of our patients."

Asked how Horizon will prevent burnout among the volunteers putting in the extra hours, she said the health network continues to work "very diligently" on recruitment and hopes to have a rotation of staff as others agree to join in the weeks and months ahead.

Model inspired by Formula 1 racing

The initiative, known as high-intensity interval theatre (HIIT), is recognized as an efficient way to complete "a month's worth" of surgeries in a single day, while not putting added pressure on a hospital's regular Monday through Friday surgical schedule, according to Horizon.

The model was created by Guy's and St Thomas' NHS Foundation Trust, a health-care organization in the U.K., and was inspired by Formula 1 racing pit stop techniques — "achieving maximum efficiency and safety by boosting surgeons' operating time and eliminating all possible patient delays on the day."

By focusing on one type of routine procedure for the day, the turnaround time between patients is minimized and the number of patients who can be treated is maximized.

More than 2,000 people are waiting for a hip or knee replacement within Horizon.

The national benchmark for wait times for both hip and knee replacements is 182 days.

Across Horizon, five out of 10 hip replacements are completed in an average of 313 days, and nine out of 10 are completed within 524 days.

For knee replacements, five out of 10 are completed in 391 days, and nine out of 10 are completed within 590 days.

Starts this weekend in Moncton

The goal of the HIIT initiative is to complete three to four orthopedic surgical procedures every Saturday in each of the four locations, with the rollout starting this weekend at the Moncton Hospital.

Once the program is fully implemented, between 12 and 16 hip and knee replacements will be completed each Saturday, and between 72 and 96 surgeries will be completed over the next several months.

A lot of planning has gone into the initiative, said Amy McCavour, executive regional director and co-lead of surgical services.

"Surgery can't perform in a silo, so we have considered all of our upstream and downstream processes, like inpatient units, and all of our multidisciplinary teams," she said.

All of the necessary supports, such as physiotherapy, will be in place to ensure patients can be discharged in a timely manner, ideally within 24 hours, said McCavour.

Horizon projects the initiative will cost roughly $500,000, when factoring in the cost of the joint replacement as well as required staffing resources, said McCavour.

Funding has been secured through the provincial government, she said.

Opposition supports initiative

Health Minister Bruce Fitch, who announced the high-intensity interval theatre initiative in the legislature Thursday, said he's pleased to see it move ahead.

He called it a "big step" in making "a dent" in surgery wait times, coupled with some of the "other pieces of the puzzle," such as the cataract clinic in Bathurst, announced last month, which will free up operating space at the Chaleur Regional Hospital for other procedures.

Green Party Leader David Coon described the HIIT initiative as "much-needed."

He said he hears from constituents who have been waiting "a very long time" for a hip or knee replacement and are "quite worried" about their condition deteriorating while they wait.

Some are "getting to the end of the rope in terms of their confidence that they're going to be able to make it to surgery before they lose their mobility entirely."

Coon said he looks forward to hearing about the pilot's results.

It would be nice to see the health minister and his team pay similar high-intensity attention to addressing some of the other pressing problems in the health-care system, such as the "logjam" in emergency departments, he added.

Could be extended

Liberal health critic Rob McKee, the leader of the Official Opposition, said he believes the HIIT initiative could prove positive.

"It might be an outside-the-box type of idea that this government is bringing forward that would get people through the door, get people off that wait list," he said.

McKee questioned, however, why other hospitals, such as ones in the north "that oftentime are getting neglected," aren't included. If the program is successful, he'd like to see it expanded, he said.

Hip and knee replacements are performed at Horizon's Dr. Everett Chalmers Regional Hospital in Fredericton, the Moncton Hospital, the Miramichi Regional Hospital, the Saint John Regional Hospital; and St. Joseph's Hospital.

If the pilot proves successful, it could be extended at least into March, Melanson said.