It's been close to five years since the provincial government decided to reduce surgical wait times, but the end is nigh, as is success. The province is continuing to boost surgical capacity to meet the demand all across the province.
"The Saskatchewan Surgical Initiative was initiated to support the province," said Ron Epp, director of the initiative. "Within the first year, we reduced wait times down to no longer than 18 months, then 12 months, then six months."
Now, the province is aiming to reduce all patient wait times down to three months.
The Humboldt District Health Complex itself has already reached and exceeded its surgical goals for the year of 2013. The backlog was reduced and they are able to now assist with surgery waiting lists in the broader Saskatoon Health Region.
"We're contributing to reducing surgical demand," said Diane Shendruk, director of the Humboldt District Health Complex.
"We're very fortunate because we have specialists come out to Humboldt and perform those procedures."
Currently, the hospital operates day surgeries on Mondays, Wednesdays, Thursdays, and Fridays. If they were to increase surgical capacity, they may have to look at operating on Tuesdays, which would be a complex process.
"It would depend on what kind of surgeries we were looking to expand to," said Shendruk. "We would have to ensure we have the staff and surgeons available. That would be the primary focus."
Previously, the province had been struggling with surgical demand due to a lack of surgically trained operating room (OR) nurses. To combat this problem, the province graduated 36 OR nurses in the last two years to deal with people retiring or moving to a different position.
"In the past, one of the things we've seen were surgical blitzes, which would bring in a whole bunch of surgical capacities. We would get caught up in them and then go back to systems as usual, but didn't fix the problem that created it in the first place," said Epp. "So we looked at what were the (root) problems and addressed those. Some of them were we didn't have enough surgical capacity, not enough nurses, or enough surgical OR time."
For each of those issues, the province has been providing solutions. Regarding the lack of surgical capacity and surgical OR time, the province began by increasing the number of facilities. One of the ways in which they did that was by contracting third party facilities in a publicly funded system.
"We've purchased OR time in these systems," said Epp. "We have the same surgeons doing the surgeries in these private clinics. What we've done is they're all scheduled into those operating theatres, so there are more (surgeons available) to perform surgeries and they provide the equipment and OR nurses."
In other words, they rent out the operating theatres, nurses, and equipment in order to increase surgical capacity.
While Humboldt has responded to these changes well and has reached their surgical targets due to increased efficiency, the Saskatoon Health Region is still behind.
"We still have a challenge in Saskatoon and Regina," said Epp. "Both are provincial services and provide highly specialized services, which means additional demand. Another challenge that was seen just recently in Saskatoon is that with the population increase, we're also seeing an increase in demand for surgery."
According to Epp, the region is seeing 800 more cases than originally forecasted. The number of cases is predicted based on the demand. To cope with this demand (and demand in other facilities around the province), patients are encouraged to have their surgeries in their own local hospitals (such as Humboldt) to balance out the demand at each facility.
Previously, due to the backlog, patients were instructed to have their surgeries at larger neighbouring facilities. However, now that the backlog is reduced or eliminated, patients are being made aware that their surgeries can be performed closer to home.
"The biggest challenge is probably getting surgeons to travel," said Epp. "They usually prefer to do it at their own facility if they can book the OR time because they know the location and the attending nurses."
According to Shendruk, another challenge when it comes to increasing surgical capacity is the sheer complexity of the process. While patient wait times are a priority, scheduling surgeries has to take into account a variety of factors.
"We need to look at patients first to understand what procedures are required to make sure they receive the right care in the first place," said Shendruk. "We need to look at scheduling for the OR, we have to make sure we have the right surgeons coming out as well as post care available for the patients."
With the Humboldt District Health Complex being part of the Saskatoon Health Region, the process also has to take into consideration the types and amount of demand of each of the facilities. Some surgical procedures need to be done in tertiary hospitals while others can be done in rural hospitals. They have to look at capacity, human resource, and equipment availability and see what facility would be best to handle the demand.
"We have no concerns about Humboldt," said Shendruk. "It's a new hospital with two beautiful operating theatres and well equipped for the surgeries that we do perform out there. They're certainly meeting the greater demand for the diagnostic endoscopy procedures."
