2023-08-02 15:11:12
The plan to catch up on surgical operations presented two and a half months ago by the Quebec government and the Federation of Medical Specialists of Quebec is beginning to be deployed in hospitals in the province. Between mid-June and mid-July, the surgical “level of activity” slightly exceeded that recorded in the same period before the pandemic, according to the Ministry of Health and Social Services (MSSS).
But behind this statistic hide less encouraging realities, doctors point out.
The average level of surgical activities rose to 101% in Quebec health establishments between June 17 and July 15, according to data obtained from the MSSS. To determine this rate, the ministry compared the number of operations carried out in a given period compared to that recorded on similar dates in 2018 and 2019, i.e. before the pandemic. In its calculation for the current year, Quebec has included interventions carried out by designated private clinics, such as specialized medical centers (CMS).
“This means that there are as many surgeries, and even a little more, than the pre-pandemic average for the same period”, specifies the MSSS in an email. “In comparison, the total activity level last year for the same period was 95%. So this is an improvement. »
Without the contribution of specialized medical centres, the average level of surgical activity in Quebec operating theaters reaches 83%. This rate is barely 49% in Outaouais and 65% in Laval.
“Obviously, the CMS make a big difference on the volumes” of interventions, observes the president of the Quebec Association of Surgery, the Dr Patrick Charlebois. “Our hospitals have not recovered because of labor issues. We are still faced with long waits for the patients who are the sickest. He recalls that specialized medical centers perform “relatively simple surgeries on patients with low surgical risk” that do not require hospitalization.
More complex cases must still wait, laments the Dre Annie Deshaies, head of the CIUSSS de l’Estrie orthopedic service. In her region, the situation is going from bad to worse, she reports. “We are talking regarding patients who suffer while waiting for their intervention,” says the specialist. While we promised them a three to six month wait, we have to tell them that they are going to wait two years before being operated on in Sherbrooke right now. »
A crisis shakes the operating theater of the Fleurimont hospital. Only 20 nurses and nursing assistants work there at the moment, when there should be 75, indicates the FIQ-SPSCE. “The holders of evening and night positions are all absent,” says Marika Turcotte, acting vice-president of labor relations for the union. According to the CIUSSS, 40 full-time nurses and nursing assistants are needed “to allow the optimal functioning” of the operating room, a figure that the union considers “totally insufficient and unrealistic”. For the moment, only five of the nine operating rooms are open, says Dr. Deshaies. “With rooms closed like that, we are not catching up at all. We’re more into pedaling to try to keep our heads above water. »
Some regions are doing better
Health facilities are doing better. Some manage to put in place measures for the remedial plan for surgeries. At the MUHC, teams were mobilized on Saturday to carry out interventions, according to Dr.r Patrick Charlebois, who practices there. “We hope that this catch-up plan will really accelerate with the end of the holidays,” he said.
The government has set an ambitious target: to reduce the number of patients who have been waiting for surgery for more than a year to 2,500 — the pre-pandemic level — by December 31, 2024. Currently, nearly than 15,000 patients are on this out-of-time waiting list.
Our hospitals have not recovered because of labor issues. We are still faced with long waits for the patients who are the sickest.
At the CISSS de Lanaudière, cancellations of interventions in cases 12 months and older are scrutinized, according to the head of the general surgery department, Dr.re Manon Giroux. “If I know that orthopedics has canceled two cases of 12 months and more, I will see why,” she said. Normally, he has to ask my permission to cancel for 12 months or more. »
Revision surgery has begun in his region. “Sometimes there are rooms that end at 8 p.m. rather than 4 p.m. because there are staff who agree to stay,” she says. We also employ retired nurses. » Recruits are deployed more quickly in the field. “We no longer do training in all specialties before letting them work, says the Dre Giroux. Now, we train them in three specialties and we continue to train them when we can so that they can be guards. These new nurses work alongside experienced nurses.
At the Charles-Le Moyne hospital and at the Haut-Richelieu hospital, the operating theaters have returned to their pre-pandemic pace, according to Dr.r Jean-François Cloutier, head of the surgery department of the CISSS de la Montérégie-Centre.
To achieve this, measures aimed at training more nurses have been put in place. The duration of bouldering training has been reduced from regarding 12 months to 6 months, he says. “There was a lot of wasted time before,” says the Dr Cloutier. “We have set up a pairing service. An experienced nurse monitors the apprentice throughout the six months to ensure that she always has immediate supervision and feedback. »
The head of the department of surgery foresees a “similar level of production to 2019” this fall. But he does not believe that elective surgeries will be able to be performed on weekends anytime soon. “The problem we have is that we are still working with a reduced workforce,” he said. And the caregivers on the ground are tired.
Level of surgical activities from June 17 to July 15, with and without CMS
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