Medical team approach will soon provide new hips and knees within 20 weeks

An article in the Edmonton Journal October 25, 2006 demonstrates the need to include the whole health care team to address backlogs in the health care system.


Reducing the wait and pain: Medical team approach will soon provide new hips and knees within 20 weeks
The Edmonton Journal
Wed 25 Oct 2006 
By Jodie Sinnema

EDMONTON - The wait for hip and knee replacements will soon shrink dramatically, Capital Health says.

Within a year, almost all patients needing replacement surgery should be able to have their operations within 20 weeks of their initial consultation, down from about 82 weeks, the region says. The improvement is thanks to a more efficient approach.

Last year, a pilot project cut waiting times for the surgeries by 90 per cent. Patients waited 10 to 12 weeks from the time they had their first consultation to their actual surgery, down from about 82 weeks previously.

But only some patients had access to the new system, where a team of nurses, physicians, physiotherapists and dieticians helped the patients instead of the surgeon doing most of the work.

By this time next year, Capital Health hopes 90 per cent of patients needing new hips or knees will have surgery within 20 weeks. That's slightly longer than the pilot project's wait of 12 weeks, partly because many patients need time to organize their work schedule and prepare for their surgery through diet or exercise. Patients needing urgent care will have surgery more quickly Dr. Don Dick, head of orthopedics at Capital Health, said Tuesday.

Dick said it will take a year to achieve the 20-week target because there's a backlog of about 2,000 people.

Dedicated operating rooms in the Royal Alexandra, Misericordia and University hospitals will be hopping this year as orthopedic surgeons reduce that waiting list. They plan to perform surgery on 3,000 people, up 300 from last year.

Under the new model, which will cost the region an extra $5 million this fiscal year, patients get counselling prior to surgery to prepare their bodies. Little such help was available before, so some surgeries had to be cancelled at the last minute since patients weren't ready.

The new system also weeds out patients who don't qualify for surgery. This is done by health professionals at a central clinic in College Plaza. Previously, the surgeons had to see every patient and make most of the decisions.

Stuart Hosler, 71, waited for one year to have his left knee replaced. During that time, he couldn't walk around the block. He was taking Tylenol 3s to relieve the constant pain, yet his surgery kept being postponed.

After joining the pilot project, his knee was replaced in two months. The day after surgery, he started physiotherapy.

His wife, who had her right hip replaced under the old system, had to wait six weeks after surgery to get physiotherapy. Frances Hosler waited two years for her surgery, then had a hard time contacting her doctor for medical advice after it was complete.

"My experience was much better than my wife's," said Hosler, who skied this past winter for the first time in years. "It was the team approach that really impressed me."

A report by the Canadian Institutes for Health Information, to be released today, found the number of knee and hip replacement surgeries done in Canada has almost doubled in the past 10 years.