Plan to restart surgeries slowed by long-term care patients in N.S. hospital beds

The Nova Scotia Health Authority says it’s well on its way to restarting all services after the COVID-19 pandemic slowdown, but one of the biggest hurdles is beds occupied by patients waiting to move into long–term care homes.

Dr. Greg Hirsch, the senior director of perioperative services, said they’re now operating at 67 per cent of the volume compared to this time last year.

“I think we’re doing well, even very well,” he said. “We’re maintaining a sufficient amount of resources in the hospital to deal with any uptick in COVID.”

While hospitals in Nova Scotia have always grappled with patients waiting to move into long–term care homes, Hirsch said the situation now is significantly worse.

“There’s been quite a blockade there, as you could appreciate,” he said, referring to outbreaks in facilities including Northwood in Halifax where 53 people died.

There are 343 people in Nova Scotia hospitals waiting to be moved to long–term care. That’s up two from the month before.

More than 3,200 operations and procedures were cancelled in Nova Scotia during the pandemic. (Syda Productions/Shutterstock)

Hirsch describes it as a trickle-down effect. Surgeons can’t work extra days to catch up if the patients need to be admitted into hospital because there’s nowhere for them to stay.

He said across the province, hospitals are booking just a few weeks in advance so they know what they’re dealing with as far as bed capacity.

“A lot of these places are doing more day surgery than they’d really like to,” he said.

The health authority is also following public health guidance to keep 15 per cent of the beds free, in case COVID–19 cases flare up again.

“What we really need to do is get over 100 per cent because you can’t work off a backlog until you’re above what you were doing before,” Hirsch said.

Instead, he said surgeons are being innovative. For hip and knee replacements, he said, there’s a greater emphasis on a new system done in other jurisdictions that sees some patients released the same day.

Catching up on 3,200 bookings

During the peak of the COVID-19 outbreak in Nova Scotia, hospitals across the province were operating at 25 per cent capacity as a way to focus resources and prevent further spread of the coronavirus.

The only surgeries to go ahead were life-saving treatments and urgent cases. Just over 3,200 operations and procedures were cancelled.

One month after restarting, 22 per cent of those operations have happened, and a further 11 per cent are scheduled in the next few weeks.

Hirsch is asking anyone who has seen their condition deteriorate to contact their physicians. He works in cardiology and knows of at least one patient who ended up in heart failure after their procedure was postponed.

They were able to save the patient.

There are 343 people in Nova Scotia hospitals waiting to be moved to long–term care. (Shutterstock / BlurryMe)

“I’m only aware of near misses,” he said. “But I am not categorically saying we haven’t had worse than that.”

Hirsch is now a part of a research project that will look at the adverse effects of the shutdown and the impact it had on people who needed health care.

In the meantime, he said while people might be eager for the health-care system to get up to full speed again, they do have to be cautious.

On Tuesday, Nova Scotia saw its first positive COVID-19 case in three weeks. The case was related to travel and the province said that person is in self-isolation.

“The system needs to be able to take care of those folks. I think we only need to glance south of the border, I’m not suggesting we have what’s going on down there, but this thing can turn around quickly,” he said.

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