CEO says Health P.E.I. plans community surgical clinics to tackle long wait times

Health P.E.I. is working to reduce surgical wait times for Prince Edward Islanders by creating community-based surgical clinics to handle things like hip and knee replacements, says CEO Melanie Fraser.

The initiative was mentioned in the recent throne speech, where the Rob Lantz government announced it is exploring a community-based model to address the lack of available operating rooms for surgeons and expand access to services outside of hospitals.

"We're going to work to put out an RFI [request for information] to have a vendor come and build the capacity for us in terms of building the footprint in the community, and then we're in the process of working with our physicians to build the plan for how to operate it," Fraser told CBC's Island Morning.

"This will be our doctors and our nurses performing surgeries in a community-based clinic. I know people jump to a conclusion about it being a private centre. This is really about just expanding our footprint and creating more [operating room] capacity overall so that we can continue to increase and deliver more surgeries for people."

Fraser said the first clinic could be set up within 12 to 18 months.

"Now that's for hips and knees," she said. "We are also doing the same for gynecological procedures, women's procedures that can be standardized."

'We are making progress'

CBC News recently told the story of Lisa-Beth Glassman, a P.E.I. woman who has waited for more than two years for knee replacement surgery.

After a year-long wait just to connect with an orthopedic surgeon and another year waiting for an in-person appointment, she was told in June 2023 that she needed surgery. As of this month, she still does not have a scheduled date for that operation.

According to Health P.E.I.'s website, 50 per cent of knee replacement patients are treated within 368 days, and 90 per cent within 715 days.

Island Morning11:20What is Health P.E.I. doing to reduce wait times?

Hundreds of Islanders are waiting for various surgeries and many are waiting months — if not years — to get them. Last week, we told you the story of one of those Islanders. Today, we speak with Melanie Fraser, the CEO of Health P.E.I., about what’s being done to reduce wait times and improve access to care.

Fraser said the health authority is working to bring those wait times closer to national benchmarks.

"We are making progress," she said.

Currently, the Canadian Institute for Health Information's national hip replacement benchmark is within 26 weeks (182 days), and the same number applies to knee surgeries.

To shorten her wait, Glassman proposed having the operation in another province, and was able to get a surgery slot at a public hospital in Toronto. She said her request to have Health P.E.I. pay for the Ontario surgery has been denied twice, despite a letter from her surgeon.

Fraser said: "It's not Health P.E.I.'s decision to make where surgeries are funded and how they're delivered. So that's a decision for the government to make. 

"What Health P.E.I. is doing is we're working on multiple fronts… to increase the capacity and the throughput in the system."

She noted that P.E.I. does have arrangements with other provinces to deliver services that can't be provided on the Island, such as vascular and other highly specialized procedures.

"And then we do have services on the Island that we are trying to build and get back to national standards, and particularly hips and knees. But all of the surgeries, the general surgeries and procedures, are those areas that we're working hard to make improvements on."

'No single solution'

Fraser said solving the issue of surgical wait times requires a comprehensive approach, addressing every stage of a patient's journey.

"There's no one single solution," she said. "This is a pathway, and we have to build capacity along each and every step."

The full pathway includes an initial visit with a family doctor, referral to a specialist, diagnostic imaging such as MRIs, pre-surgical preparation, surgery and post-surgical rehabilitation, Fraser said.

To address bottlenecks in this process, she said Health P.E.I. is working to recruit more family doctors, as well as reduce diagnostic imaging wait times. One effort includes the province paying for Islanders to receive MRIs at a privately operated clinic in Moncton, which has contributed to reduced MRI wait times on P.E.I.

Fraser said patients like Glassman often wait long periods just to get an MRI — and that contributes to the overall surgical wait time.

"So by solving that, we also contribute to solving the overall surgery wait list."

Building capacity beyond hospitals

Fraser said about 6,000 surgeries are performed annually at the province's two hospitals: Queen Elizabeth Hospital in Charlottetown and Prince County Hospital in Summerside. Health P.E.I. is working to increase that capacity by 10 per cent, which would amount to roughly 600 additional surgeries, she said.

Even so, she added, "that's not going to be enough to keep pace."

That's why Health P.E.I. thinks it essential to expand into the community with standardized procedures done by Island doctors and nurses, Fraser said.

"If you want to achieve the results that the rest of the country is achieving, this is how they've done it, by being able to expand rapidly into community spaces, looking at opportunities to create focus centres for things like colonoscopies and endoscopies and cataracts and hips and knees," she said, adding that those procedures can be done safely in the community.

An example is the recent opening of a cataract clinic in Charlottetown, to perform some eye surgeries. 

"Every time we pull those out of the hospital into a dedicated footprint, we also increase what gets done in the hospital, so it lifts the whole system overall," Fraser said.