Surgical backlog at Hamilton Health Sciences at almost 9K cases amid continuing pressures

HHS is reporting a surgical backlog of some 6,700 adult cases and close to 2,200 pediatric patients in wait as of early April 2023. Don Mitchell / Global News

Hamilton’s top hospital network is still feeling occupancy pressures and struggling to return to pre-pandemic surgical capacity levels.

Despite a significant decline in viral infections as of Monday, particularly in COVID cases, Hamilton Health Sciences (HHS) says their surgical capacity is only at about 85 to 90 per cent of normal with a backlog of 6,765 adult cases and close to 2,172 children on a wait list.

It’s a situation the president of McMaster Children’s Hospital Bruce Squires characterizes as “really concerning” and says will require some sort of funding help from the province to solve.

Of particular concern is the 1,400 kids that have passed recommended wait times to receive a particular surgery.

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“Of course, when a recommended surgery is delayed for a child, that can have impact on their future development,” Squires suggested.

“Often these things are really targeted around a developmental window that could be a physical developmental window (or) it could be emotional. When we miss those, in some cases, that means it will impact the future of that child.”

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Squires says a recently opened “overnight unit” should help ease some of those current pressures by providing procedures via a late night stay that will see a patient discharged early next morning.

“It’s going to allow us to provide surgery to kids who traditionally might have needed an inpatient bed at the hospital and therefore sometimes might have found their surgery cancelled because we’re so pressured for inpatient beds,” Squires explained.

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Ontario Health, with support from the Ministry of Health, has been meeting with regional health-care providers since January to offer solutions which include moving some procedures outside main pediatric hospitals.

Space issues as well as continuing demand for service and supply are the root of stresses across the Hamilton networks.

During an operational update last week, HHS operations executive vice-president and COO Sharon Pierson revealed efforts are being made to address the “daunting backlog of cases” through surgical recovery initiatives across the network.

“There is an inordinate amount of work occurring for us to work through this backlog … and there’s a number of initiatives in progress both for the adults and the pediatric population,” Pierson told staff.

Emergency visits remain relatively low and stable compared to the heights seen in the previous two years particularly with the Juravinski on Concession where capacity expansion projects have helped with offload wait times.

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However, as of the update, acute care occupancy was still over 100 percent at the facility.

Some 70 unfunded beds, introduced in late 2022, are still in use daily to offset occupancy pressures with former acute care patients awaiting transfers or discharge.

Current supply pressures also means untraditional use of post care units for general patients will continue as well as post-acute beds at regional rehab and chronic care facilities like St. Peter’s on Maplewood Avenue.

“And we’re seeing … as you would expect in these situations, significant number of patients waiting in the ICU to move to their lower level of care,” Pierson said.

She went on to say recruiting also remains at the top of the solutions list amid staffing shortages, particularly among perfusion and pathology specialists.

As of Monday, total vacancies at HHS were at about 1,600 with some 450 nursing positions vacant.

Retirements year over year in April have decreased by 8 per cent compared to the same time period in 2021-2022.

The agency is also exploring expansion of “admission avoidance strategies” working with home health and virtual care partners to lessen emergency department as well as post care visits.

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HHS was able to tackle a potential MRI booking problem which was on course to hit a backlog of some 20,000 waits in the coming fiscal year.

Hiring additional booking clerks has alleviated that issue somewhat with some 16,000 patients needing imaging having an appointment as of early April.

In late March, the Canadian Institute for Health Information revealed 900,000 operations were put on hold between March 2020 to September 2022 due to multiple waves of COVID that dried up hospital resources.

Ontario pegged their adult surgical backlog at about 200,000 as of mid-January before announcing a move to expand adult surgeries to private clinics to ease waitlists.

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