Nursing crisis pressures knee, hip wait times
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The Stefanson government has put a dent in wait times for hip and knee surgeries in Manitoba. That’s the good news.
The bad news is the number of patients on the wait list remains well above pre-pandemic levels and the surgical backlog that built up in 2020 and 2021 is largely unchanged since last August.
Wait lists for many hospital procedures, including orthopedic surgery, skyrocketed during the COVID-19 pandemic, as operating room staff were redeployed to treat the influx of patients infected with the novel coronavirus.
With ORs back to full capacity last year, wait times for hip and knee replacements fell below pre-pandemic levels in December for the first time in 2022, according to the most recent data from the province’s diagnostic and surgical recovery task force.
The median wait time for hip replacement was 16 weeks in December, down from 28 weeks in June (that’s the point at which half of patients wait longer and half wait less). For knees, it fell to 23 weeks in December from a high of 48 weeks in August.
Both are below where they were in December 2019, just prior to the pandemic. That’s a significant improvement.
The main reason: orthopedic surgeons have increased caseloads. They performed 5,060 hip and knee replacements in 2022, slightly above the 5,049 completed in 2019.
Still, the delays are far too long. Many people linger on the list longer than the posted wait time, which doesn’t include the referral period to see a specialist.
Wait times also differ between individual surgeons and hospitals. The median for knee replacement at Brandon Regional Health Centre, for example, is 34 weeks, compared with 22 weeks at Concordia Hospital in Winnipeg.
Despite the recent success, wait times could rise again if the province is unable to increase surgical capacity beyond existing levels. Demand for hip and knee surgery is rising by an estimated five per cent a year, owing largely to a growing and ageing population.
If hospitals can’t keep pace with that growth, wait times will almost certainly increase.
Meanwhile, the number of people on the wait list for hip and knee surgeries is still higher than it was prior to the COVID-19 pandemic.
There were 3,293 waiting for the surgery in December 2022, up from 2,197 in December 2019.
Meantime, the backlog of orthopedic cases that built up during the pandemic is still estimated at 1,040. While that is down from 1,557 in January 2022, it hasn’t changed much since August (1,140).
Sending patients out of province for hip and knee surgery, which began late last year, has helped reduce wait times somewhat. However, there hasn’t been a huge uptake (less than 60 by the third week of December). That number is expected to rise in 2023, but the long-term solution is building more capacity at home.
Task force officials say Manitoba needs to perform about 6,000 hip and knee procedures a year to clear the backlog and bring down wait times. If the province can’t reach that level in 2023, and if it’s unable to increase capacity by a further five per cent annually in subsequent years, wait times will almost certainly rise again.
Plans to open a new operating room at Concordia this year could help. It’s expected to add up to 1,000 more hip and knee procedures a year.
However, there are concerns Manitoba’s nursing shortage, which appears to be getting worse, could impede that progress. Nurses are required not only in operating rooms but also to staff recovery beds for in-hospital patients. (Most hip and knee surgeries require overnight stays.)
There are already signs the nursing shortage may be having an impact on hip and knee surgeries. While the total number of procedures last year was slightly higher than in 2019, it began to tail off towards the end of 2022. It’s not a great sign.
Cutting the ribbon at the new Concordia operating room, expected as early as spring, would be a powerful image for the Stefanson government prior to the next election (on or before Oct. 3).
Whether the new OR will have a major impact on wait times will largely depend on how well government can solve the nursing crisis. So far, that isn’t looking promising.
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.