Moving surgical recovery into high gear

Alberta is moving forward with a rapid action plan to transform Alberta’s surgical system by putting patients first.

As part of this priority work, chartered surgical facilities in Edmonton and Calgary will provide about 35,000 cataract and other eye procedures under new contracts with Alberta Health Services (AHS) this coming year. This is 25 per cent more than last year, and will drive down wait times and build resilience and capacity in the health system under the province’s Sustainability and Resiliency Action Plan.

Performing these ophthalmological surgeries in community clinics frees up operating room space in hospitals to provide more complex surgeries, including complex cataract and retinal procedures, plus ear, nose and throat surgeries. Budget 2022 provides $133 million over three years via the Alberta Surgical Initiative to expand and build new operating rooms in hospitals across the province.

A new independent surgical recovery lead has also been established to oversee, track and provide dedicated focus and rigour to surgical recovery. The new lead will keep the government and AHS on task and accountable to ensure people get better surgical care faster, based on recommended wait times.

Reducing wait times for eye surgeries

Albertans will have shorter waits for cataract surgeries, as AHS harnessed the competitive market to land on contracts with chartered surgical facilities to provide high volumes of eye surgeries at lower per-unit costs while also meeting existing standards of care.

Beginning April 1, new contracts with Holy Cross Surgical Services and Vision Group Canada will provide at least 20,000 ophthalmology procedures in Calgary this coming year (15,000 cataract surgeries and 5,000 other eye procedures) and at least 10,000 cataract surgeries in Edmonton chartered surgical facilities. AHS is working with chartered surgical facilities to provide 5,000 more cataract surgeries in Edmonton as soon as possible.

The successful vendors were chosen following a request for proposals in April 2021 to increase ophthalmology surgeries for Albertans, since cataract surgeries have historically had long wait times.

Surgical recovery lead

The province has also established a Canadian health-care executive, Ronan Segrave, as Alberta’s new independent surgical recovery lead with Alberta Health. With his experience transforming and strengthening surgical services and health systems in Canada and the United Kingdom, Segrave has already started work to develop an Albertamade action plan to first reduce the surgical backlog created by the pandemic, then forge ahead on the Alberta Surgical Initiative so that every Albertan gets their surgeries within clinically recommended wait times.

• According to the Canadian Institute for Health Information, Alberta ranked seventh among provinces for providing cataract surgeries within recommended wait times.

Chartered surgical facilities

• Alberta is a leader in Canada in partnering with chartered surgical facilities to increase access to much-needed surgeries.

• Chartered surgical facilities have been offering publicly funded surgeries to Albertans since the 1990s.

• The College of Physicians and Surgeons of Alberta accredits chartered surgical facilities for quality and safety standards.

• Surgical wait times have been affected by the pandemic, but chartered surgical facilities boosted access to surgeries whenever possible.

• They performed about 45,500 surgical procedures from April 2020 to March 2021, more than ever before, and about 11 per cent more than before the pandemic.

• Chartered surgical facilities currently deliver about 17 per cent of surgeries performed in Alberta.

Surgical recovery lead

• Ronan Segrave has supported and advised on more than 30 major operational reviews of surgical services in hospitals in the United Kingdom and Canada, including in Ontario, Manitoba and British Columbia.

• As chief operating officer of Health Sciences Centre in Winnipeg from December 2017 to June 2021, he led the transition to a new provincial health organization, Shared Health, and delivered $20 million of operational improvement with significant reductions in length of stays in acute care and reduced wait times in the emergency department.

• His review of surgical services in Winnipeg led to the redesign of patient pathways, the development of an Ambulatory Surgical Centre to help address the COVID-19 surgical backlog, and implementation of an initiative called surgical smoothing. This uses a more nuanced triage and scheduling system for surgeries so that scheduled surgeries don’t compete or conflict with emergency surgeries for operating room time and resources.

• While working in London, U.K., for

England’s Department of Health, then later for Ernst & Young and other consultancy firms, he led the expansion of independent sector ambulatory surgical centres in the English National Health Service. This led to significantly reduced wait-lists for orthopedic and cataract surgery and achieved a national maximum

18-week wait target for patients.