LETTER: Island Health changing approach to delivering surgeries

On May 18, Island Health once again started providing non-urgent scheduled surgeries, along with other health authorities across B.C.

From mid-March, while we continued to provide urgent scheduled and emergency surgeries, non-urgent scheduled surgeries were postponed in all B.C. health authorities to ensure hospitals had the capacity to respond to COVID-19.

Our resumption of non-urgent scheduled surgeries is a key and welcome step in ensuring patients and their families know we’re focused on providing the thousands of surgeries which were postponed or had not yet been scheduled. With this step, we’re not just catching up on these postponed surgeries, we’re fundamentally changing our approach to delivering surgeries too.

By June 8, we had contacted over 4,600 Island Health patients to determine if they were ready to proceed with their surgeries. This date also marked our completion of 3,555 scheduled and unscheduled surgeries, up 59 surgeries, or just over four per cent, from the week earlier. Across Island Health, surgery renewal is underway.

All eight Island Health operating sites offering non-urgent scheduled surgeries are now performing at full capacity. Surgery renewal is occurring in Cowichan District Hospital, Nanaimo Regional General Hospital, North Island Hospital – Campbell River, North Island Hospital – Comox Valley, Royal Jubilee Hospital, Saanich Peninsula Hospital, Victoria General Hospital, and West Coast General Hospital. Island Health has contracts with two private surgery facilities, and they’re also running at full contracted capacity. Over the summer and fall, we’ll add additional resources and capacity by opening additional operating and procedure rooms, extending daily operating room hours and adding weekend slates to the schedules.

The surgery renewal commitment makes clear this first part of renewal focuses on those most in need and where we can safely increase surgeries while still protecting capacity for any surges in COVID-19 cases. This includes patients who need their surgeries in less than four weeks; patients who have had their surgery postponed; and patients who have waited more than twice their clinical benchmarks. We’re also focused on patients whose surgeries can safely be conducted as day procedures or outside of the main operating room. This includes procedures like cataract surgeries.

Achieving the priority surgeries of the first phase means temporarily moving specific focus away from some surgeries. This will include some dental and hip-and-knee arthroplasty surgeries, and for patients anticipating these surgeries, and for their surgical teams, this is difficult news. But this priority focus on patients most in need will adapt. As surgery renewal proceeds in Island Health, and as we deliver these priority surgeries, full orthopedic and dental surgeries not captured in the initial priority groups will be undertaken.

Our surgery renewal commitment to patients and the significant changes it requires will do much more than see us get back to the number of surgeries performed pre-COVID-19. It will enable us to keep up with new demands for surgery and complete the surgeries lost to COVID-19 within approximately 17-24 months.

We’re making sure we can handle both surgery renewal and the needs of COVID-19 patients. As with many of our normal routines and practices which have been changed by COVID-19 throughout Island Health, we’re learning as we go and adapting to get patients the surgeries they need. Every day, our hospitals are reviewing operating room capacity to prioritize urgent cases, including urgent oncology and emergency surgeries.

These are significant changes to ensure patients get the surgeries they need. But the success of these efforts is highly vulnerable to external forces. As Dr. Henry and health officials around the globe have indicated, we are likely to see a second wave of COVID-19 this fall. A second wave this fall, or a surge in new cases before then, will again impact our hospitals and the number of surgeries which can be safely performed.

Each one of us still has a critical job to do. We must stay committed to stopping the spread of COVID-19. We must continue to use the skills Dr. Henry and Dr. Stanwick have taught us to stop the spread of COVID-19.

Nurses, doctors, and all health-care workers involved in surgery renewal are counting on us. If we do our job, they can do theirs. Everyone in Island Health is 100 per cent all-in on surgery renewal. Each of us needs to stay 100 per cent committed to stopping the spread.

The surgery renewal commitment announced by the minister of health on May 7 is a massive undertaking, and the most ambitious surgical project ever attempted in Canada. In our Island Health COVID-19 fight, and our surgery renewal commitment, we are all counting on each other to continue to stand apart and work together — our surgeries depend on it, and so does our health.

Leah Hollins, chair

Island Health Board of Directors

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