What the Healthcare Plan Means for Surgeries

A few weeks ago, when I reported on the provincial government’s “redevelopment” plan for Cape Breton Healthcare, I noted that it called for the transfer of surgeries currently performed in the Northside General and New Waterford Consolidated Hospitals (both of which are scheduled for closure) to the Cape Breton Regional and Glace Bay General Hospitals.

CBRM Health Redevelopment (Source: YouTube)

CBRM Health Redevelopment (Source: YouTube)

The numbers were quite startling to a non-medico like myself: 1,700 additional annual surgeries at the Cape Breton Regional and 1,600 at the Glace Bay General. I also noted that the plan did not include any expansion of operating room (OR) capacity, and I wondered how all these additional surgeries would be accommodated.

But the thing about being a non-medico is that you don’t know anything about the inner workings of hospitals. My knowledge of the Cape Breton Regional, for instance, doesn’t extend much beyond my recent discovery that I could pay for parking at a machine in the lobby of the Health Park (although the day I discovered this, I also discovered the machine was out of order) and my semi-mastery of the waiting room system at the blood clinic (where I recently took two numbers by accident).

Luckily, as a reporter, I have the ability to call up the hospital and ask. (Mind you, the CBC’s Peggy MacDonald got there before me and answered many of my questions before I’d even had a chance to ask!) But I spoke this week with the Cape Breton Regional Hospital’s site chief for Surgery, Dr. Rod McGory, and its director of PerioOperative Services, Troy Penney and I think I can add a few details to the mix.

 

Perioperative

Penney began by defining Perioperative Services:

[I]t is pretty much everything before and after surgery, so that includes our pre-admission clinic, our day surgery clinic, our ORs of course, recovery room and then our in-patient surgical unit.

We discussed the current capacity of the system and I learned that there are three ORs in the Glace Bay Hospital, one of which is dedicated to Ophthalmology “leaving two ORs that are able to be used.” The hospital is currently what Penney called a “Monday to Thursday” operation but “the plan is make them a five-day-a-week operation.” The Glace Bay Hospital doesn’t do on-call (emergency) surgeries.

The Cape Breton Regional Hospital has six ORs currently in use and one that is not in use but will be opened as part of the redevelopment plan to provide additional capacity. The Regional performs scheduled surgeries from 8:00 AM to 4:30 or 5:00 PM, “depending on the day,” said Penney, from Monday to Friday. Nursing staff works until 11:00 PM after which physicians and nurses are on call (“seven days a week, 365 days a year”) until about 7:00 AM the next day for emergency surgeries.

Penney said the Regional Hospital performs about 3,000 scheduled general anesthesia procedures each year, about 1,800 local anesthesia procedures and about 2,800 GI (endoscopy) procedures.

Dr. McGory added that the Regional also performs about 2,000 unscheduled or emergency procedures each year.

The New Waterford Consolidated Hospital has one OR and the Northside General has two.

Penney told me the the numbers of surgeries to be transferred in the initial announcement of the redevelopment plan were “estimations, nothing really concrete,” because the details of which procedures would be done where have yet to be worked out, but here’s some of the changes planned:

Surgeries now performed at the New Waterford Consolidated Hospital will go to the Glace Bay Hospital with the exception of surgeries performed under general anesthesia, which will go to the Cape Breton Regional Hospital.

Gastrointestinal (GI) procedures (colonoscopies and gastroscopies) now performed at the Northside General Hospital will be performed at the Endoscopy facilities in the new-build Health Centre in North Sydney. Penney says they also plan to transfer some of these procedures from the Glace Bay and Cape Breton Regional Hospitals to the expanded North Sydney facilities.

In terms of capacity, Penney said he wasn’t concerned about the transfer of surgeries to the Cape Breton Regional: moving some “from North Sydney and some from New Waterford here won’t be a huge burden to the system, probably no burden at all.”

 

Reorganization

Dr. Rod McGory (Source: NSHA VIMEO)

Dr. Rod McGory (Source: NSHA VIMEO)

Dr. McGory stressed that the goal of the redevelopment plan was “not to lose capacity” but to “reorganize where it’s done.”

I think it’s actually a good time for us here, right now, to reorganize the way we do things. We’re looking at capacity and we’re actually not going to lose any capacity and hopefully, through some efficiencies, we may gain more capacity.

One of the things that’s very exciting for some of the surgeons is that we will be [moved] into one facility where we can be collaborative more, instead of spread over too many facilities where you may not have that same collaboration or you may not be able to [have a] colleague come in to help you in the OR. So I think that’s going to be very beneficial to many of the surgical specialists and especially some of the newer surgeons.

Asked about the effect the reorganization would have on staffing, Penney said:

First we have to determine what our staffing needs will be, when we start looking at models of how we’re going to be delivering that care, so kind of early to say what our staffing needs will be, but our intent is to have the people that were doing the services in the various locations continue to do them in a different location. Just a reorganization.

Penney said the “functional planning” stage of the redevelopment plan is expected to take six to nine months and the Cape Breton Regional Hospital has taken its first steps:

[W]e’ve assigned various managers aspects of the redevelopment and they’re going to start working and creating some sub-working committees to look at the new-build in North Sydney, the redevelopment in Glace Bay and a few of the redevelopments here at the Regional Hospital…[W]e have a lot of work and a lot of exciting work to do.

Featured image (clockwise from upper left): Glace Bay Hospital, New Waterford Consolidated Hospital , Northside General Hospital (courtesy NSHA), Cape Breton Regional Hospital (by Verne Equinox, CC BY-SA 3.0, from Wikimedia Commons)

 

 

 

 

 

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