North East Surgical Optimization Project
The NE LHIN undertook a review of surgical services currently being delivered in hospitals throughout the region to ensure that access and quality care is maintained in the future. The mandate of the project was to review the surgical volumes, diagnostics and resource requirements to meet Northeastern Ontario’s surgical needs. A Surgical Optimization Steering Committee was established to steer the project. The Steering Committee has developed the following Terms of Reference to assist them with the ongoing needs of surgical services in the North East..
The Surgical Optimization Steering Committee is moving forward with the three-year action plan to carry out the 33 recommendations stemming from the Surgical Optimization Study Report, May 22, 2009.
The following four priorities have been addressed by the Surgical Optimization Steering Committee:
Thoracic Surgical Oncology
- HRSRH and SAH to meet quality standards of Cancer Care Ontario (CCO).
- HRSRH to develop a distributed diagnostic model.
- HRSRH has moved forward with compliance with the CCO standards for Thoracic Surgical Oncology and has received their level 1 designation.
- HRSRH has implemented thoracic cancer multidisciplinary case conferences (MCCs) that occur monthly and are available for participation at SAH by videoconference.
- Address request from SAH to enhance their vascular program within the context of creating a singular vascular program in Northeastern Ontario.
- The vascular surgeons from Sault Area Hospital and Hôpital regional de Sudbury regional Hospital met on February 8, 2011 to discuss the EVAR request from Sault Area Hospital.
- As outlined in the Endovascular Aortic Replacement Report, February 8, 2011 the vascular surgeons have agreed to maintain status quo in the distribution of the vascular surgery in the NE.
Orthopaedic Surgery – Hips and Knees
- Standardized access for patients across the NE LHIN requiring assessment for primary hip or knee replacement facilitated through the use of a common referral form.
- Implementation of a web-based patient management system to track Wait 1 based on the Referral Tracking System.
- Timely patient access to a multidisciplinary assessment to facilitate triage based on a client's potential need for surgery.
- Reduction in wait times for hip and knee replacement surgery across the NE LHIN.
- The North East Hip and Knee Replacement Program (NE HKRP) has been implemented across the NE LHIN. The NE HKRP includes five Joint Assessment Centre sites – Hôpital régional de Sudbury Regional Hospital, North Bay Regional Health Centre, Sault Area Hospital, Timmins and District Hospital and West Parry Sound Health Centre.
- A NE HKRP Coordinator has been hired and is responsible to coordinate the activities of the NE HKRP.
- A web-based referral and tracking system has been developed for the NE HKRP. The project is being led by HRSRH.
- For additional information on the NE HKRP, please click here.
Call schedule for urgent/emergent surgical care
Call Schedule Minutes:
- Identification of a coordinating mechanism and procedure to address regional call schedule.
- Identification of an online tool to be used to publicize call schedules and monitor gaps in call coverage in Northeastern Ontario.
- Identification of the role of hospitals of insufficient size to provide 24/7 coverage in order to maximize coverage provided, including holidays and weekends.
- Dr. Isser Dubinsky, Project Lead, and Dr. Tim Zmijowskyj, Project Associate, were hired by the NE LHIN to work on the call schedule project. Read more about how the North East LHIN works with physicians to better meet region's surgical needs.
- In the first phase of work, project team members contacted several of the NE LHIN hospitals and physicians to gather additional information and schedule interviews for input on the process. For additional information on the outcome of these meetings, please refer to the Summary Notes for the identified surgical areas.
- The Surgical Optimization Steering Committee will be reviewing the Call Schedule Report, June 27, 2011 at their September 2011 meeting.
The surgical optimization Steering Committee has developed a three year action plan to address the 33 recommendations stemming from the Surgical Optimization Report. The action is as follows:
Year 1 – 2011/12
- Thoracic surgical oncology – meeting Cancer Care Ontario (CCO) standards (completed).
- Orthopaedic – addressing wait time targets and repatriation issues.
Year 2 – 2012/13
- HHR – development of a surgical health human resource plan.
- Call schedules – implementation of call schedule strategies.
- Call schedules – identification of coordinating mechanisms.
Year 3 – 2013/14
- HHR – roll-out of surgical human resource plan to address access to general surgeons across Northeastern Ontario.
- Impact analysis – analysis of hospitals’ ability to support their designated surgical role.
Integrated care pathways – promote the development of standard integrated pathways for common surgical procedures.