N.L. sets sights on same-day hip and knee replacements to cut surgical wait-list

In a bid to cut down Newfoundland and Labrador'ssurgical backlog, some hip and knee replacement surgeries could be a single-day outpatient procedure as early as this fall, the provincial government announced Thursday.

Premier Andrew Fureysaid Thursday the goal would be to do about one-fifth of hip and knee replacementsas a same-day procedure,without the need for a hospital stay keeping beds open and allowing the province to cut down on its long wait-list for surgeries.

"We're setting a goal on target of 20 per cent as outpatients, [and] I think we can even push that a little higher," Furey said. "We know the size of the wait-list now, and once this project is up and running we'll be able to track it."

Furey, an orthopedic trauma surgeon himself, says doctors have faced challenges in completing surgeries due to both the COVID-19 pandemic and the cyberattackon Newfoundland and Labrador'shealth-care system.

The province completed about 1,700joint replacement surgeries per yearbefore the pandemic, said Furey, but that number has dropped by about 900 since then.

Doing more surgeries will require more resources, said David Diamond, CEO of Eastern Health, on Thursday.

Part of the nuclear medicine unit at St. Clare's Mercy Hospital will be renovated to allow more outpatient surgeries. The updatewill extend the hospital's day surgery unit and create space for health-care professionalsto prepare patients for surgery and monitortheir recovery.

Thework is expected to be finishedby the end of the summer, Diamond said.

The renovation will costabout $350,000, with $440,000 annually to staff four full-time outpatient surgerystaff members.

Furey said certain medical criteria will have to be met for a patient to qualify same-day surgery. Recent advancements have created a lessinvasive surgery with a lower risk of infection, he said, allowing people to go home sooner, leaving hospital beds.

"More importantly, what it does is it saves in the in-patient cost," said Furey. He said in-patient care costs $1,000-$2,000 a day. "So over time, this will actually save money while accomplishing what we all set out to do, which is to do more surgeries."

Conditions worsenwith two years of delays

Most people on the surgical wait list are waiting for hip and knee joint replacements, according to Eastern Health orthopedic surgeon Dr. Keegan Au.

He estimates that around 2,500 people in the province are waiting for the procedure and said their conditions have likely gotten worse as a result of delays over the past two years.

"There's been a lot of patients that have been waiting a long time, partly because of the pandemic and other factors," Au said Thursday.

"Some of them are patients of ours for many years, and to watch them suffer in the wait for the procedure has not been an easy thing for us to do. That's one of the reasons why we're trying to really think outside the box and try to do some of these things that may help in reducing our backlog."

Diamond said Eastern Health will likely start with one to two outpatient procedures per week in the fall, with the goal of completing around 200 surgeries per year as the project ramps up.

Furey says the province is also workingto find ways to cut the backlogsacross other surgical disciplines.

Opposition leader David Brazil said it's good to see the government acknowledge that surgical wait times need to be reduced but said he hasconcerns about people being sent home immediately after surgery.

"We do accept the fact that need to do something immediately but we can't do it at the risk ofthem not healing properly or now having to call an ambulance to come to [emergency]and wait eight or 10 hours to be assessed again," he said.

If people need to return for a second surgery, he said, it would back the system up even further.

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