DUBBO Hospital general manager Debbie Bickerton has defended its elective surgery performance in response to new data showing patients are on average waiting at least 100 days more for some procedures as compared to the rest of NSW.
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The latest Bureau of Health Information (BHI) Hospital Quarterly for January to March 2016 reveals that waiting times for many types of elective surgery are worse than the state average.
During the quarter the wait for orthopaedic surgery was 336 days compared to the state average of 142. Corresponding figures for cataract extraction were 357 and 253, and ear, nose and throat surgery 303 and 183.
The BHI data showed that the waiting times in the January to March 2016 quarter at Dubbo Hospital for orthopaedic surgery and ear, nose and throat surgery had reduced from the same period in 2015 by 15 and 19 days, respectively.
The wait for cataract surgery had grown by 24 days.
Ms Bickerton has greeted the data with advice that a strategy put in place almost three years ago is paying off, along with the surgical department’s relocation early this year to a new clinical services building.
She said the move had built “theatre capacity” by 25 per cent, from three to five full theatres operating five days a week.
The general manager told of
the hospital being “at capacity
for elective surgery” three years ago.
She said back then the hospital’s same-day surgery cancellation rate had been about 19 per cent, the highest in the state for want of a “designated emergency surgery session”.
“Normally we would bump the less urgent elective surgery, the ones that hadn’t been waiting as long,” Ms Bickerton said.
Unable to meet demand for elective surgery, the public hospital leased theatre space at Dubbo Private Hospital.
The general manager and her executive also conducted a review of surgical lists with a subsequent strategy implemented in October 2013.
Ms Bickerton said theatre sessions were increased for the likes of hip or knee replacements.
“At the time patients were waiting an average 380 days, so that’s come down,” she said.
“We had people waiting as long as 15 and 16 months for a joint replacement.”
Ms Bickerton said sessions were reduced for less urgent elective surgery that were “getting done within a couple of weeks”.
“We knew some surgeries would wait slightly longer but well within their recommended waiting time,” she said.
“Other types of surgeries where the wait was too long, like hips and knees, we looked to bring back inside the recommended time of 12 months, which is exactly what happened.
“What we have done is improve equity of access so we don’t have people getting non-urgent surgery in two weeks and other people waiting for surgery for 15 months.”
The success of the strategy rested on “creating access to emergency surgery during business hours”.
“Our cancellation rates on the day of surgery have come down to around two or three per cent,” Ms Bickerton said.
“It’s a massive improvement. We’ve gone from the worst in the state to almost on par with the best.”
The general manager said the hospital’s data as provided by the BHI had “most definitely” improved because of the strategy.
“We are so happy with our performance with elective surgery,” she said.
Ms Bickerton pointed to waiting times for people who received surgery by urgency category.
She reported that in the January to March 2013 quarter 97 per cent of urgent patients were treated at Dubbo Hospital within the recommended time of 30 days, 90 per cent of semi-urgent patients within 30 days and 94 per cent of non-urgent patients within 365 days.
The BHI’s latest Hospital Quarterly reveals corresponding figures of 99, 99 and 95 per cent, respectively, for the public hospital.
“At the end of May our percentage of patients getting their non-urgent surgery within the 365 days was actually 98 per cent,” Ms Bickerton said.
The state average in the January to March 2016 quarter for the urgent, semi-urgent and non-urgent categories was 100, 97 and 96 per cent, respectively.
The general manager said waiting times were also impacted by “normal population growth” and the employment of more doctors.
“More doctors see more patients who are added to the waiting list,” she said.
Ms Bickerton said the blow-out in the waiting time for cataract extraction surgery partly reflected a doctor reducing his days of work in 2015.
“He’s come back now we have capacity back here at the public hospital,” she said.
“We’re doing four lists of eye surgery a month, so one a week.
“The result of that is we will reduce the wait.”
Ms Bickerton said there was “huge growth” in the number of people seeking cataract surgery in the state.
She said a public eye clinic in Dubbo has impacted on waiting times.
“It’s a good thing because people who need cataracts done are now getting on the list whereas I don’t think they were previously,” the general manager said.
Ms Bickerton said “utilising every surgery list” was bring waiting times down.
She said since February extra theatre time had been assigned to orthopaedics, ear, nose and throat, urology and general surgery because they were
“putting the most pressure on the waiting lists”.
“So in the next quarter we will see a huge improvement on the median days wait for those areas,”