Operating rooms empty for that it delegates to the private

Photo from the archives, Olivier Jean
The vast majority of the operating theatres of the hospitals of Quebec were under-used last year, show data compiled by The Newspaper. The Royal Victoria hospital (of which we see an operation room on the photo), has obtained the second best result, 95 %

Héloïse Archambault

Monday, 7 August 2017 06:30

UPDATE
Monday, 7 August 2017 06:30

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While thousands of Quebecers have to wait several months to be made and that the government pays millions of dollars for surgery in the private operating theatres of the hospitals are not used to 100 %, has compiled The Log.

“The doctors are right when they say that they are prevented to operate, responds to Paul Brunet, president of the Council of the protection of the sick. What is ironic, is that it sends the private patients. You pay twice. We are paying for the public infrastructure that is not used, and the private infrastructure. “

Only one block to 100 %

Through the Law of access to information, The Newspaper has compiled the rates of use of the operating theatres of the hospitals of Quebec. Result: only the Montreal general hospital, McGill university Health Centre (MUHC), has reached the rate of 100 %, the last year.

In this regard, the management is responsible to have “worked extremely hard to optimize the use of our operating rooms,” writes Vanessa Damha, a spokesperson for the MUHC.

In particular, procedures are performed in the clinic preoperative assessment and preparation of patients, installation of intravenous, etc), which optimizes the time to the block.

According to several directions of hospitals, the optimal target referred to is 85 % (see text).

However, on the 63 responses received, only 13 hospitals had achieved this rate. For the past five years, the data show a general improvement of the use.

Patients waiting

During this time, 13 215 Quebecers have been waiting for more than six months to be operated on, as of the date of the 27 may last.

And from may 2016, the government has paid out more than 11 000 surgeries in three private clinics. Aiming to reduce congestion in the waiting lists, these operations have cost $9.2 million.

At the Centre of integrated health and social services (CISSS) in the North-of-the-Island-of-Montreal, 716 patients were operated on in private.

“We use [the clinic] Rockland to decrease our waiting lists, particularly for bariatric surgery,” says Hugo Larouche, a spokesperson for the CISSS. It gives access to a room of more. “

According to the ministry of Health and social Services, making maximum use of an operating room (100 %) is eight hours per day, five days per week (248 working days per year).

The vast majority of hospitals follow this standard, but the MUHC is a schedule of 8.5 hours per day. Directions have also clarified that the surgeries take place outside the regular schedule are not included in the rates calculated.

“Why not open up more blocks of hours ? There are rooms brand new as it was built, and that we don’t use “, said Mr. Brunet, who believes that the tight budget explains the lack of use.

Less used regions

In regions, the blocks are often less crowded. The CISSS du Bas-Saint-Laurent, a shortage of anesthesiologists has had a negative impact for a few years.

Also, it is noted that the outlying hospitals have the mission to provide basic services, but that “the density of population makes it so that it would be surprising that the set of these small blocks to achieve the set targets in terms of occupancy rates,” says Lise Chabot, a spokesperson for the CISSS.

A target of 85 %

Several hospitals are intended to be of use to the operating block of 85 %, and recognize that efforts must be made to optimize the surgery.

“We are aware that there is still work to be done,” said Hugo Larouche, a spokesperson for the Centre for integrated health and social services (CISSS) in the North-of-the-Island-of-Montreal.

Cleaning time

Most hospitals aim for a utilization rate of blocks of 85 %. The rest of the time is used in the preparation of the patient and cleaning the room. Case extended, cancellations, emergencies : several factors chamboulent the schedule.

“What often happens, it is all the factors that come to thwart the planning “, says Hélène C. Gaudreault, co-manager clinico-administrative of the operating theatres at the Centre hospitalier de l’université de Montréal (CHUM).

“The goal is to always improve in order to give more time to the surgery and avoid cancelling operations that have been planned. “

To note that several cases end later than the scheduled time. Last year, the rate of CHUM ranged between 71 % and 82 %.

The merger will help

Although the management of an operating theatre is a complex one, the CISSS du Nord-de-l’île-de-Montréal believes that the reorganization of the network of 2015 will help to better manage time.

“It integrates the services and that improves the management of the case,” says Mr. Larouche. It is necessary to improve the planning and scheduling of surgeries. “

Utilization rates of operating rooms

Montreal general hospital (MUHC) 100 %
Rimouski 78 %

Royal Victoria (RVH) 95 %
Hotel-Dieu (CHUM) 77 %

Sorel 93 %
Montreal neurological hospital (MUHC) 76 %

Saint-Hyacinthe 93 %
Cowansville 76 %

Lachute* 92 %
Sainte-Anne-des-Monts 76 %

Maisonneuve-Rosemont 91 %
Roberval 74 %

Pierre-Boucher (Longueuil) 90 %
Drummondville 74 %

CHU de Sherbrooke 89 %
Mont-Laurier* 74 %

Gaspé 87 %
Jonquière 73 %

Hosp. Montreal children’s (MUHC) 86 %
Shawinigan 72 %

Chicoutimi 85 %
Saint-Luc (CHUM) 71 %

Laval 85 %
Saint-Jérôme* 71 %

Saint-Jean-sur-Richelieu 85 %
Victoriaville 71 %

Joliette 84 %
Baie-Comeau 71 %

Terrebonne 84 %
Jean-Talon 71 %

Saint-Eustache* 84 %
Fleury 71 %

Granby 82 %
Lac-Mégantic 68 %

Rivière-du-Loup 82 %
Alma 67 %

Institute of cardiology 82 %
Amqui 66 %

Sainte-Justine 82 %
Memphremagog 64 %

Notre-Dame (CHUM) 82 %
Matane 62 %

Pointe-Claire 82 %
Lachine (MUHC) 61 %

LaSalle 82 %
Dolbeau 60 %

Santa Cabrini 82 %
Sainte-Agathe-des-Monts* 60 %

Sacred Heart 82 %
Témiscouata 60 %

St Mary’s 81 %
Sept-Îles 58 %

Pavillon Rosemont (Hos. Maisonneuve) 81 %
Kamouraska 48 %

Maria 81 %
Amos 47 %

Charles-LeMoyne (Longueuil) 80 %
Val d’or 42 %

Chandler 80 %
Rouyn-Noranda 34 %

Trois-Rivières 79 %
La Tuque 17 %

Verdun 78 %

Source : DHSS. Given the most recent provided by the hospital (usually in 2016-2017 or 2016)
*Given 2015-2016, dated march 5, 2016.
Editor’s NOTE: The HSS calculates a maximum use of 8 hours per day, 5 days per week (248 working days per year).
The MUHC and the Montreal heart Institute have hours respective of 8.5 h and 10 h per day.
The CISSS de la Montérégie-West had not responded to the Newspaper at the time of publication.
The Centre hospitalier universitaire de Québec did not provide rates of use of his operating theatre to the Newspaper, and said that such a calculation is not produced. However, it is assured that the priorities operative are filled to 100 %.
The Block of The Hat serves to emergencies and to the local population
Patients waiting for surgery for more than six months in Quebec

• Cataract : 1131
• Hip : 289
• Knee : 574
• Day surgery : 8078
• Surgery with hospitalization : 2305
• Bariatric surgery : 838

Total : 13 215