Three patients were on stretchers in emergency at the Health Sciences Centre Thursday waiting on urgent surgery for broken hips, while Eastern Health cancelled orthopedic elective surgeries due to lack of beds for patients to recover in.
Eastern Health said three elective orthopedic surgeries — two knee replacements and a hip replacement — were cancelled Thursday due to over capacity at the Health Sciences Centre in St. John’s.
Elective or planned surgeries refers to those that can wait and could be subject to choice, as opposed to urgent or emergency surgeries.
The Telegram asked Eastern Health to officially confirm elderly patients with hip fractures were waiting in emergency on stretchers at Health Sciences and was told there were three patients waiting on urgent surgery to repair their hips. Those patients would not be considered elective and Eastern Health insisted the urgent patients’ surgeries weren’t cancelled, as they would be performed within the 48-hour recommended time.
Waiting in ER
However, while their surgeries technically weren’t cancelled the patients could not get the surgery they needed Thursday, even though a surgical team was in place to operate on them. They had to wait in emergency.
There is a national wait-time benchmark of surgery within 48 hours because the risk of mortality increases the longer a patient waits to have a broken hip repaired.
The Telegram has also learned two electives were cancelled Wednesday.
Prior to cancelling the elective surgeries Thursday, Eastern Health said it made every effort to accommodate the patients. That included reviewing the number of expected discharges in surgery units and discharging patients where possible. It also considered transferring eligible patients to facilities closer to their home communities or to nearby hospitals and reallocating beds from other units for surgery patients.
Cancelling elective surgeries is a last resort for Eastern Health, a spokeswoman said in an email statement.
Thursday, surgeons were rebooking patients’ elective surgeries. Eastern Health apologized for the inconvenience. Since January 2014, about 30 elective surgical procedures have been cancelled at the Health Sciences Centre due to there being no inpatient bed for post-operative recovery.
Eastern Health plans summer bed closures annually, but due to increased demand for inpatient medical services at the Health Sciences Centre, beds that were due to close for the summer have remained open at the site.
The health authority said it is trying to improve patient access to beds.
Delaying surgery for hip fractures after 48 hours can contribute to increased morbidity and mortality, however, this is not the case for hip replacements, Eastern Health said. Patients diagnosed with a hip fracture require emergency (not elective) surgery and would be done as soon as possible.
Eastern Health has made strides in recent years in cutting hip and knee replacement wait times.
According to Eastern Health’s wait time reports for the fourth quarter of the 2013-2014 fiscal year (Jan. 1 to March 31):
‰ 83 per cent of hip fracture surgeries were completed within the national benchmark or 48 hours.
‰ 98 per cent of hip replacement surgeries were completed within the national benchmark of 182 days.
‰ 96 per cent of knee replacement surgeries were completed within the national benchmark of 182 days.