An idea to streamline the operating room got patients into surgery sooner
CBC
When a surgeon saw patients stuck waiting for orthopedic surgeries, he designed a better operating room — one that's publicly funded and can do the procedures faster and more efficiently.
Now, it's a model other hospitals are interested in copying.
Dr. Abdel-Rahman Lawendy, chief and medical director of the ambulatory surgical centre at London Health Sciences Centre, reimagined the OR — one of the most resource-intensive places in a hospital — for select orthopedic surgeries.
His "Surgi-centre" idea takes certain patients away from the large, standard operating rooms full of staff and equipment, paring that down to just what is needed to operate on ambulatory patients — people who can walk after surgery and go home the same day. Examples of the surgeries performed include repairing a torn ACL in the knee, a common sports injury. And the surgeries are done at ORs outside of the hospital, though they're managed by the institution.
In comparison, standard hospital operating rooms need to be prepared for complex surgeries that require about six staff per room and a full set of sterilized instruments, just in case they're needed.
"By cutting all of that stuff out, you essentially drive the cost down significantly and then increase the efficiency, which in our system doesn't necessarily translate to saving more money," Lawendy said. "It translates into treating more patients."
Treating more patients is particularly important now as the COVID-19 pandemic lengthened an already long wait-list for non-urgent surgeries, hospital officials say.
The average wait time in Canada last year for hip replacements was about 25 weeks, according to the Canadian Institute of Health Information.
But Mary Curry waited only 14 weeks for a forefoot reconstruction. Arthritis had already resulted in months of foot pain that limited the Denfield, Ont., patient's mobility and left her psychologically exhausted.
She and other patients at the Nazem Kadri Surgical Centre go home the day of their operation.
Since Curry's pain was not life-threatening, without Lawendy's innovation, she likely would've had to wait longer for the surgery to resume walking on her heel, given the average wait times.
Patients qualify for the ambulatory surgery option at the London hospital if they're relatively healthy and are having minor foot, ankle or hernia surgeries that require minimal equipment.
"The crew was amazing," Curry said as she was wheeled out of the smaller, high-efficiency OR. "Stayed awake until I started feeling the pushing and pulling."
Jillian Holbrough, the surgical centre's clinical manager, said staff are at least 30 per cent faster than in the hospital's standard ORs. They perform between 10 and 15 surgeries a day in two operating rooms. "It was a bit frightening at first, the thought, because it was so innovative," Holbrough said of the initial hesitation.
