Cancelled Surgery

ELECTIVE (NON-EMERGENCY) SURGERY IN THE MAIN 6th floor OPERATING ROOM

Over 95% of Dr. Ing’s patients proceed with their surgery date as planned.   Occasionally your surgery date must be changed.  Patients with cancer, sudden blindness, infection or acute trauma have priority over non-emergent cases.

Remember to have your family doctor complete the pre-operative form, or your surgery may be cancelled.  Do not to eat or drink anything after midnight, (except your blood pressure pills) when going to the operating room. Some patients forget this and their surgery is cancelled.  

Rarely, you may be waiting in the hospital the day of your surgery, and the surgery is cancelled.   The hospital cannot afford to keep the main operating room open past 3:30 pm, unless the surgery is an emergency.  Ontario hospitals have been on a strict global budget, and have not received incremental funding to keep pace with inflation for years, even though our patients are getting older and sicker.

The hospital operating room is run much like an airport.

AIRPORT                               HOSPITAL

Check-in                               Admitting department,  6th/7th floor

Plane                                   Operating room

Pilot                                     Surgeon

Co-pilot                                Anesthesia doctor

Landing strip                       Recovery room

 

If you do not check-in at the airport well ahead of time, you will miss your flight.  If you do not arrive at the hospital 2 hours before your appointed time, you may miss your surgical slot.

Dr. Ing is like a pilot, and the plane is like Dr. Ing’s operating room.  Dr. Ing is given only one “plane” (operating room) per day, and he requires a co-pilot for every flight.  The co-pilot is the anesthesia doctor.  If the co-pilot is unavailable, the plane does not take off.  If the anesthesia doctor is not available, Dr. Ing cannot operate.

The plane has only one seat for one passenger (patient) at a time.  A new passenger cannot board the plane, until the plane lands and the previous passenger leaves.  If no runway is available to land, the pilot must circle with the passenger until one becomes available.   After 3:00 pm, no planes are allowed to take off, (no further surgeries) because all flights must finish by 3:30 pm.

In other words, except for emergencies, the hospital will not allow surgeries to start after 3:00 pm, due to budget constraints. (If your surgery requires more than a half hour, the cut off time may be even earlier.)

The most common reason why an operation is cancelled the day of surgery is because the recovery room (the landing strip) closes several times a day due.  Sick patients, and nursing shortages slow down the recovery room.  The hospital only budgets for the average number of nurses it needs.  It does not have enough money to pay extra nurses to be on “stand by”.  Dr. Ing is not given any advance warning when, or how many times the recovery room will shut down on a particular day.  When the recovery room shuts down, a general announcement is broadcast to all surgeons in the operating rooms.

Dr. Ing does NOT overbook the main operating room time.  A computer tracks Dr. Ing’s average times for surgery, and alerts the hospital if there are too many surgical bookings for one day.  Unfortunately there is tremendous variability in the anesthesia time and recovery room time each patient requires.  Surgery may be delayed because some patients are infirm, have heart or breathing problems, or are difficult to put to sleep, or wake-up.  Occasionally the anesthesia doctor is called for an emergency (cardiac arrest, to help deliver a baby etc.).  Delays may occur because equipment needs to be modified, or extra instruments must be requested from central supply.

Children, diabetics and sicker patients are scheduled early in the operating day.  If you are relatively healthy, you do not get to “cut in front”.  Calling Dr. Ing out of the operating room to talk to you the day of surgery will only delay everyone’s surgery more.  If Dr. Ing knows your surgery will be cancelled, he will notify you as soon as possible.  Dr. Ing cannot come out in the middle of an operation to notify you.  He must finish the operation, and wait until the patient is stable before leaving the operating room.

If your surgery is cancelled, Dr. Ing apologizes.  However no amount of complaining to the “pilot” will get your “plane off the ground” when the “airport” is shut down.    If your surgery is cancelled, contact the secretaries, who will try to rebook your surgery usually 1-2 weeks later.

The funding problem is the same at every Canadian hospital Dr. Ing has worked at.  Every surgeon in every Canadian hospital has had to deal with surgical delays and cancellations.    In addition to his medical responsibilities, your surgeon wheels patients to the recovery room, helps make the surgery beds, runs to get supplies for you, helps clean the operating room between cases, and often goes without lunch so your surgery can be completed.  Our hospital and staff are already being pushed to maximum efficiency.  Unless funding is increased, our OHIP system cannot improve.

You can complain about the surgeon and the hospital, but the lack of government funding has removed any flexibility from our hospital work environment.

If you are upset, consider contacting the government and give them your opinion about hospital cuts.  The solution may require higher taxes, but your health is important. 

The Ontario Health Coalition suggests the following: