NB aims to reduce surgical waits with ‘HIIT’ lists

SAINT JOHN, NB – Members of Horizon Health Network’s Surgery Program are taking an innovative approach to performing surgeries on patients who have been waiting the longest for orthopaedic surgeries. Surgical teams in Fredericton, Miramichi, Moncton and Saint John will complete a “blitz” of up to 96 surgeries – primarily orthopaedic (hip and knee replacements) – on Saturdays in November, December, January and February. Typically, operating rooms (ORs) do not run planned surgeries on weekends.

The goal of the initiative is to complete three to four arthroplasties in each of the four locations on a Saturday. This means, when the program is fully implemented, between 12 and 16 hip and knee replacements will be completed each Saturday and between 72 and 96 surgeries will be completed over the next several months.

“All New Brunswickers deserve accessible healthcare, and we are committed to providing that every day,” said Margaret Melanson (pictured), Horizon’s interim president and CEO. “This initiative is an innovative and efficient way to continue to address our systemic challenges and barriers to providing access to surgery.”

This initiative is known as “High-intensity interval theatre (HIIT)” lists. HIIT lists are recognized as an efficient way to complete “a month’s worth” of surgeries in a single day. HIIT lists are scheduled for Saturdays so that pressure isn’t put on a hospital’s regular schedules.

The model was created by Guy’s and St Thomas’ NHS Foundation Trust, a healthcare organization in the United Kingdom. Their initiative (high intensity theatre, or HIT, lists) was inspired by Formula 1 motor-racing pitstop techniques – achieving maximum efficiency and safety by boosting surgeons’ operating time and eliminating all possible patient delays on the day.

This initiative involves intensive planning and preparation from a multidisciplinary team of healthcare professionals, including anesthetists, surgeons and registered nurses (RNs), licensed practical nurses (LPNs) in OR, day surgery, Post Anesthesia Care Unit (PACU) and inpatient units, as well as patient care attendants (PCAs), respiratory therapists, environmental services, medical device reprocessing (MDR), medical imaging, laboratory, pharmacy, physiotherapy and occupational therapy staff.

“I am extremely appreciative of the healthcare workers who are taking time from their weekends to provide this exceptional care for their patients,” said Melanson. “They have gone above and beyond to make this initiative possible.”

This also involves several pre-operative meetings with patients, to ensure the best candidates are selected. Patients waiting the longest will be the first group considered for this initiative.

The HIIT initiative started Saturday, Nov. 26 at Horizon’s The Moncton Hospital (TMH), and other hospitals will begin in the following weeks. The initiative will continue on Saturdays through December, January and February.

This initiative also supports the Government of New Brunswick’s provincial health plan, Stabilizing Healthcare: An Urgent Call to Action, specifically, the action area of creating improved access to surgery.