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Innovation Fast-Tracks Specialty Surgical Care
Vancouver, March 25, 2009 — Thanks to a recent investment of $5.6 million in surgical innovation at St. Paul's Hospital, referral wait times are down, surgeries are up, and recovery times are shorter than ever for Lower Mainland patients in need of lower extremity (foot and ankle) and upper extremity (hand and wrist) surgeries (also known as distal extremity surgeries).
The improvements come as part of the Distal Extremities Surgical Project, announced in October 2008 as one of the first initiatives to receive support under the Province's Lower Mainland Innovation and Integration Fund.
“The Distal Extremities Surgical Project is an outstanding example of how patients can benefit from innovation in our health-care system,” said Health Services Minister George Abbott. “In projects right across the province, innovation in health-care delivery is shortening wait times, expanding service and improving access to care.”
In just six months, St. Paul's Hospital has launched a centralized intake, assessment and surgical referral process for two high-volume clinics for patients with distal extremity orthopedic conditions, allowing physicians to see an additional 5,000 new referral patients per year. This has been paired with an innovative operating room using a swing room concept that will generate 450 new distal extremity surgeries by March 2010. Already, these innovations have allowed surgeons to nearly double their number of surgical cases (from 3.3 per day in September 2008 to 5.6 per day in December 2008).
The reductions in wait times for consultations are even more dramatic:
• The average wait time for a Foot and Ankle Screening and Triage (FAST) Clinic appointment from GP referral is two to 14 days;
• The subsequent wait to see an orthopedic surgeon after being assessed at the FAST Clinic now averages two weeks compared to previous waits of months;
• The number of patients waiting for foot and ankle surgery has dropped from 352 to 297;
• Since opening, the FAST Clinic has seen 494 new patient referrals;
• With expanded clinic space, the volume of hand and wrist patients seen at the Pacific Hand and Upper Extremity (Hand and Wrist) Clinic has significantly increased, and patients with acute injuries receive same or next day service; and
• Since expansion, the Hand and Wrist Clinic has seen 269 incremental new patient referrals.
The Lower Mainland Innovation and Integration Fund investment builds on a prior provincial commitment of $2.1 million that supported renovation of the hospital's Outpatient Department and included the opening of two new satellite operating rooms. The rooms, which opened February 2009, also employ the swing room concept and are expected to allow the hospital to handle an additional 1,000 surgical cases per year. When combined with the 450 new distal cases in the main operating swing rooms, that's 1,500 new surgical cases per year.
Patients are also benefiting from the use of innovation once inside the operating rooms: St. Paul's Hospital is the only facility in British Columbia running two operating rooms that rely exclusively on a cutting-edge technique called a regional anaesthetic block. This highly localized anesthetic technique avoids the need for general anesthetic. It allows for a speedier, less stressful and less painful recovery, leaving patients fully alert during and after their surgeries.
“The benefits of the project are already apparent,” said Dr. Thomas Goetz, head of the Division of Orthopedic Surgery at St. Paul's Hospital. “This innovative approach to funding has given way to a series of improvements that will lower wait lists for consultations and surgery. It allows doctors to concentrate on seeing patients and performing surgeries, as opposed to putting them on wait lists.”
The impact of the Distal Extremity Surgical Project is being felt beyond St. Paul's Hospital. By increasing capacity for distal extremity surgeries and reducing the time it takes to access care, the project is lessening demand on other VCH hospitals, such as Vancouver General Hospital (VGH), which can now focus on more timely care of orthopedic trauma cases. Emergency department physicians at VGH and St. Paul's can also refer patients directly to the distal clinics for assessment.
“While this project is a Vancouver Coastal Health and Providence Health Care initiative, it is benefiting patients and care providers right across the Lower Mainland, with better integration of services for all,” said David Thompson, chair of the Lower Mainland Innovation and Integration Fund. “We can expect to see more projects like this being implemented over the coming months.”
The Lower Mainland Innovation and Integration Fund was announced as a key health initiative of the 2008 provincial throne speech. It provides Vancouver Coastal Health and Fraser Health with $75 million to move beyond block funding toward a new provincewide, patient-centred funding model. The new model ties funding to performance and increased service levels in specific areas such as addressing surgical waitlists. The model also rewards integration, standardization and consolidation.
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