British Columbia has launched a major program to cut into the huge backlog of patients waiting for life-enhancing knee and hip replacements.
The chief component of the $60.5-million plan, announced yesterday by Premier Gordon Campbell, is a new surgical centre with two operating rooms designed specifically for hip and knee surgery.
The centre is scheduled to open in April at the University of British Columbia Hospital.
B.C.'s multiprong approach, aimed at bringing the maximum waiting time for new hips and knees within the new national benchmark of six months, follows on a pioneering project in Alberta that slashed waiting time to as little as 11 weeks.
But orthopedic surgeon Bas Masri, who will lead the UBC surgery centre, said Alberta contracted out some of its knee and hip operations to a private clinic.
"[We are]operating in a public hospital, so this is really the first of its kind in Canada. It's an exciting initiative," Dr. Masri said.
"We will be bringing the best orthopedic surgeons together to work in one location. This way, we hope to decrease wait times by almost 75 per cent, all without compromising care. It will be a specialized unit for hip and knee replacements and nothing else."
According to Health Minister George Abbott, 4,500 British Columbians have been on the waiting list for more than six months for joint replacement surgery.
"For many of them, it has been an inordinately long time," Mr. Abbott said. "Our goal is to bring ourselves into compliance with the national benchmark as soon as possible. This is a challenge for every jurisdiction."
In recent years, B.C., like other provinces, has been snowed under by a growing demand for hip and knee surgery, as the population has aged and replacement joint procedures have improved.
While the number of hip and knee replacement operations rose by 35 per cent in the province over the past four years, the waiting list has continued to swell.
The new UBC surgical centre, paid for by $25-million in government funds, will be able to perform 1,600 operations a year.
Meanwhile, the government is providing another $25-million to help health authorities across the province increase their surgical capacity.
And a long overdue, province-wide registry for hip and knee patients is being set up to better organize the surgical backlog. The aim is to have operating times scheduled on the basis of need rather than happenstance.
The government has also earmarked $5.5-million to establish a one-of-a-kind Research Centre of Hip Health at Vancouver General Hospital, designed to cut down on hip fractures and osteoarthritis.
"This will be the first of its kind in the world," Dr. Masri said. "It's a big thing."
While Alberta's hip and knee replacement project has garnered a lot of attention, B.C. is also drawing on lessons from its own pilot project at Richmond Hospital.
Mostly by simply standardizing procedures and focusing on better ways to use available operating rooms, surgeons there were able to reduce by 63 per cent the number of patients waiting more than 24 weeks for surgery.
Given the common-sense nature of many of these innovations, some wonder why the health-care system is only now beginning to embrace them.
"It takes planning and you are also changing the way people do business," Dr. Masri said. "That takes time."
Health policy analyst Michael Rachlis welcomed news of B.C.'s comprehensive strategy to slash surgical waiting times.
But he, too, questioned how long it often takes the health care system to implement common-sense solutions, such as B.C.'s specialized surgical centre for hip and knee replacements.
"We've just been muddling around, rarely funding anything beyond medicare's original vision of hospitals and doctors," Dr. Rachlis said. "The system really has been slow to rationalize services."