The cancellation of hundreds of surgeries in Halifax because of problems sterilizing surgical instruments at the Halifax Infirmary and VG sites are unfortunate for many levels.
This setback hurts patients and families. People suffer longer and lives are in upheaval as family members have to keep rescheduling time off work or travel to be at a hospital bedside, thereby taking a financial hit by remaining off work and/or paying for hotels as they wait.
One of the stories not told is that in the last six months Nova Scotia was cutting into surgical waitlists. With the writing on the wall for the impending merger of nine separate health silos into one unified system, health care executives started to cooperate to better utilize facilities and medical staff. For example, last spring 20 hernia patients on a Capital Health wait-list were offered the opportunity of having immediate surgery at Cumberland Regional in Amherst. It worked out. Everyone was happy, 20 people left the wait list, the system alleviated suffering and saved some costs by eliminating their on-going care and shortening surgical wait times for others.
Last spring and summer, someone lit a fire at Valley Regional Hospital and managed to organize time and teams so that an additional 115 hip and knee replacement surgeries were completed with virtually no overtime involved.
Those were positive movements. But the appearance of a mystery black powder on what were supposed to be sterilized surgical instruments and the lethargy of executives to act have produced a setback and added almost 400 operations to the backlog. Things happen in any system, but the way Nova Scotia’s new merged health authority moved and acted doesn’t suggest any fresh urgency, just old work habits under a new umbrella. Since so many of the executives are merely recycled from the previous silo-system should we expect real change?
What is disappointing is that this problem was found on April 11th. The public wasn’t told for a week. On Friday, April 24th, two weeks after the problem began a senior director at the QEII couldn’t tell the host of CBC’s Information Morning program how many sterilizers there are in HRM. The best she could say is that between the Halifax Infirmary and VG there are seven sterilizers, five of which are off line.
It is troubling that a senior person doesn’t know how many sterilizers exist in HRM. For example, wouldn’t the IWK, next door to the VG, have sterilizers? Wouldn’t Dartmouth General, across the harbour, and part of the former Capital Health Health Authority, have sterilizers? What about the Dalhousie Medical School or some of the clinics in the city? How about Twin Oaks Memorial Hospital in Musquodoboit Harbour? They may not do surgeries, but they would have to sterilize equipment used in patient care and they are within the HRM boundaries. With sterilizing equipment either in a facility in the next building or mere blocks away, it seems like we might have precipitously cancelled surgeries.
This executive said that they started last week to reach out to partners across the Nova Scotia Health System for help. Started? Why didn’t they begin as soon as the problem was found?
When asked about moving people “here” (Halifax) elsewhere for surgery she gave a convoluted, confusing response: “At this point in time we haven’t done that, but we have had those discussions at the table that if we can’t increase our capacity in the short term or in the next period of time that whether or not we‘ll have to have discussions like that, but at this point we have not engaged in those discussions yet.”
Basically, they have discussed the discussion they may have to discuss later. Once again, ours is a system where talk subverts action.
Hear the interview here: