Innovation in the Canadian Health Care System is hard. Too many people say it’s not worth it. Too many people are comfortable not altering their routine. Too many people feed into the narrative of “we can’t change anything”. Saturday October 14, we changed that narrative. The surgical team at Humber hosptial deconstructed and re-built the way we can deliver surgical care. We listened to other international centers and we were inspired. We did site visits with colleagues that “do it better” - both in a private setting and publicly delivered. We took notes. We brainstormed. We engaged the team. We trouble shooted. The boots on the ground in every role were asked how we could model efficient systems - and make them our own - and better. And yesterday we did it. Normal operating rooms in Canada involve 1 surgeon typically doing 3-4 surgeries in a day - may a few people do 5 cases. The day typically runs 8-3:30. Saturday October 14. We showed 1 surgeon can do 12 cases. Safely, efficiently and reproducibly. The OR was done at 3:30pm. The patients were all home by 6pm. I was at my sons out of town hockey game at 5. Notes: 12 anterior hip replacement cases in 7 hours using Intellijoint (no, navigational technology doesn’t take longer - it’s actually faster). Total case time from 60-minutes average down to 40 minutes. Reduced housekeeping time from 40 minutes to 15 minutes by the end of the day with parallel processes. Patient out to patient in - usually varied from 30-40 minutes - and we got it down to 15 minutes consistently. Set up time - from 30 minutes to 11 minutes using custom packs and nurse led surgical pan optimization. Take down time - from 20 minutes to 6 minutes - everyone helps. All patients were blocked, lightly sedated and moving their toes by the time they hit the Same Day Unit. We skipped the PACU entirely! No complications and all patients discharged home before 6pm, ambulating pain free and safely. Garbage reduction by 50%: 8 bags to 3-4. Linen reduction by 50%: 4 bags to 2 bags. Most importantly this idea was a group effort led by nurses, visioned by administration, supported by physicians and helped with ancillary staff. When all you hear about in Canada is how much we can’t afford and can’t do, this story showed we can do more surgical volume with better efficiencies, safely and more cost effectively. Make me proud to work at Humber Hospital and be surrounded by people who care. Makes me proud to have helped run Canada’s first Hyper-Throughput OR. If you don’t like the game, you can quit, just keep playing - or change it entirely. Special thank you to Dr Charlie DeCook, Dr Kristoff Corten and the Anterior Hip Foundation (AHF) for inspiration and guidance. #humberhealth #hipsurgery Humber River Health Humber River Health Foundation Health Quality Ontario (HQO) Conservative Party of Canada Liberal Party of Canada • Parti Libéral du Canada #ontariohealth Intellijoint Surgical Inc.
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Derek Cooke
6mo
Kudos to the whole team. A few questions. Did the team adopt ERAS principles for the work up and through put achieved? What has happened since that special day Oct 14 and may we ask that you give us some tracking info as you go along? What has been your ER visit rate before this point and may we know how you are doing a few months down the line. Hope these few questions are added stimulus to carry on the great work together! Well done and keep showing us how it can be done better.
Daniel Pincus
6mo
This is an amazing accomplishment with impressive mobilization of resources and staff. The model has also been in place for many years in Canada's public system in Vancouver Bas Masri Don Garbuz (https://pubmed.ncbi.nlm.nih.gov/32600199/).
Nick Sucharski
6mo
Congratulations Dr. Rodriguez! Thank you for leading OR innovations in Canada. You inspire pride and motivate in the operating room. You have an unprecedented, genuine will, to make Health Care in Canada more efficient and this shows in your application and execution. While some companies are not allowed to endorse you publicly on social media in Canada, I know they would thank you if they could, and are grateful to be a part of the ride. Looking forward to what's next.
Anne Forsyth
6mo
This is incredible Sebastian! Keep changing the game - this is the energy that's going to turn the tide in health care. 🙌 💪
Karim Keshavjee
6mo
Impressive Sebastian. How can we help other hospitals do the same. It's hard for the first hospital. It shouldn't be hard for all of them.
Silvy Mathew
6mo
Have to say, this is inspiring and amazing, at a time when all I see is chaos in our system. But I will say that the Ortho team at HRRH has always been accessible and my patients love it, request you guys and feel supported. To see this efficiency happen is just axing. Kudos to your team
Darren Hay
6mo
This is amazing Sebastian Rodriguez-Elizalde and precisely what healthcare needs….interdisciplinary collaboration and a willingness to step outside of “what has always been done” to drive true process reform, efficiency and outcomes🚀🚀. Congrats you and the team at Humber River Health👏🏻👏🏻👏🏻
Mudussar Ahmad
6mo
Brilliant work
Surgeon; International Speaker; Design Surgeon; Board Member
6moCongratulations for being an innovator back home. Well done. Question: are these private pay or public cases? The reason I ask is this…..if publicly funded cases are you simply going to run out of regional health care funds faster? The increased efficiency works assuming the government is willing to go over budget based on historical allocations? You may be too efficient but great work. Canada should look at the Australian public-private model. Two tier medical tourism already exists in Canada. The patients come to the US or other countries. Why not reward innovation at home and keep Canadians on home soil?