Build ‘ambulatory centres’ to clear surgical waitlists, OMA tells province

hospital backlog

Ontario Construction News staff writer

Ontario’s doctors are encouraging the province to build free-standing ‘ambulatory centres’ to help tackle surgical wait-lists that have ballooned during COVID-19 shutdowns.

The request is included in a recent report from the Ontario Medical Association (OMA) that  proposes an innovative new model of care that would reduce wait times by shifting many non-emergency, less complex surgeries to new outpatient centres.

The OMA released a comprehensive report last week, recommending construction of publicly funded Integrated Ambulatory Centres. These free-standing centres would work with local hospitals to provide OHIP-insured medical services, including surgeries and procedures, on an outpatient basis.

The idea is that building new facilities would free up beds and operating rooms in hospitals, allowing them to focus on more complex, acute and emergency patients and procedures and reduce wait times.

“Ambulatory centres in other jurisdictions have shown to deliver a more satisfying patient experience,” said OMA President Dr. Adam Kassam.

“In addition to shorter wait times, patients spend less time in ambulatory facilities than they do in hospitals and can safely return home the same day. This is combined with an improved physician and provider experience, while being able to realize efficiencies in both acute and community care.”

Ontario’s doctors believe this new model of care, the most significant change in ambulatory care in 30 years, would have widespread public support, Kassam said.

Wait times were an issue in Ontario before the COVID-19 pandemic put the spotlight on the cracks in the health-care system, with waits for many procedures longer than recommended.

A new analysis released by the OMA found that on top of existing problems, the pandemic has created a backlog of more than 21 million patient services that will take months and in some cases years to clear.

This includes a backlog of more than one million surgeries as of the end of 2021, but also preventative care, cancer screenings such as mammograms and colonoscopies and diagnostic tests such as MRIs and CT scans.

The numbers will grow when it becomes knows how many procedures were cancelled during the pause on non-emergency procedures due to the Omicron variant and when the unknown number of “missing patients” who did not engage with the health-care system during the pandemic are included.

Dr. Kassam said the health-care system must now clear the backlog while implementing the new Integrated Ambulatory Centre model, which could take five to eight years.

With the growing sophistication of surgical tools and techniques and new pain management and anesthesia options, many less-complex surgeries and procedures could be moved from hospitals to Integrated Ambulatory Centres. This could include cataract surgeries, hernia repairs, hysterectomies, hip and knee surgeries, endoscopies, ear, nose and throat surgeries and breast reconstruction after breast cancer.

The OMA proposal fully complies with the Canada Health Act and there would be no user fees or queue jumping. The centres would be fully integrated within the publicly funded, publicly administered health system.

Experience in other provinces and countries, as well as the Kensington Eye Institute in Ontario, shows that ambulatory centres can work under this model. They also have faster recovery times, lower infection rates and efficiency gains ranging from 20 to 30 per cent compared with inpatient hospital care.

A recent Ipsos survey conducted for the OMA found that Ontarians want the government to prioritize clearing the backlog of health-care services built up during the pandemic, even if it means a short-term impact on economic recovery.

In that same poll, 96 per cent of respondents said they supported the five pillars of the OMA roadmap to improve the health-care system over the next four years, Prescription for Ontario: Doctors’ 5-Point Plan for Better Health CareThe first of the five pillars is reducing backlog and wait times.

“Wait times for surgical procedures are a major problem for patients in Ontario,” said OMA CEO Allan O’Dette. “Ambulatory centres provide an opportunity for government to help reduce them and get patients the high-quality care that they need sooner.”


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