No young patients are now waiting more than nine months for surgery at the Montreal Children’s Hospital, following a reorganization of resources that took several years to complete.
The list of patients waiting 12 months or more for surgery was the first to be reduced to zero this summer, and the same goal was achieved on Oct. 31 with the list of patients who had been waiting nine months.
“It’s a moral issue … to make children wait more than a year for access to surgical care,” said Dr. Sam Daniel, chief of surgery at the Children’s. “It’s something that’s difficult for us as a team.
“So the idea was to really organize the system, then improve access and equip ourselves to eliminate the number of children waiting more than a year for surgery. It was a collective effort that started with a vision.”
The lists in question concern patients who are “available” for surgery, according to a press release — those who are ready to undergo surgery. They do not include patients who require treatment prior to surgery or those who are waiting because they need to be absent.
A multidisciplinary committee was set up to analyze the situation. However, at the heart of this achievement — which, it should be noted, is rare in the Quebec healthcare system — is the work of data analysts who have been busy trying to understand how to organize the surgery schedule to reduce the waiting list, using mathematical models to determine how many days of surgery each doctor needed based on the number of patients waiting.
“The analysis gave us a calculation of the number of rooms each (surgical) division should have based on its waiting list,” explained Sonia Guilbeault, acting head nurse of the operating rooms at the Montreal Children’s Hospital. “So we had to revise the surgical schedule, giving more time to the divisions that needed it and taking it away from those that had too much in relation to their waiting lists. It was a big communication challenge.”
A partnership was also established with the AGM Anesthesia Clinic, a specialized medical centre that was able to take on some of the simpler surgeries that did not require hospitalization.
But as important as it was, mathematical modeling was only the beginning, Dr. Daniel pointed out: we still had to be able to adequately prepare the children before their surgery and support them afterward, ensure that the necessary surgical equipment was available, and make sure that the surgeons were free to take advantage of the time they now had available.
“We had to establish safety guidelines,” he emphasized. “When you suddenly start doing things differently, you have to review all your care protocols to determine what to do if something happens.”
No young patients are now waiting more than nine months for surgery at the Montreal Children’s Hospital, following a reorganization of resources that took several years to complete.
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And that’s not counting what Dr. Daniel calls “blind spots,” such as patients who have been waiting for a year or more but whose cases are not considered urgent — “yes, but urgent for whom?” he asked — or employees who have had to make extra efforts to balance work and family life in order for the project to succeed.
Ultimately, said Guilbeault, “everyone got on board because everyone thought it was important.”
As the waiting lists melted away, she added, the teams “immersed themselves in the project” to achieve the objectives.
“We have a system that is good and caring,” concluded Dr. Daniel. “We just need to nurture it with kindness so that it continues to function.”
This report by La Presse Canadienne was translated by CityNews
