Cardiac surgeries face postponement

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This article was published 05/12/2021 (1116 days ago), so information in it may no longer be current.

Cardiac surgeries booked this week were at risk of being postponed Sunday due to ongoing strain on Manitoba’s intensive units, signalling the province has exhausted its ability to add critical care beds, a Winnipeg intensivist said.

Non-emergent cardiac surgeries were temporarily suspended on Friday and three surgeries were postponed to ensure enough critical care beds were available for general ICU patients through the weekend, according to Shared Health.

“Cardiac surgery is a little bit of a canary in the coal mine for the state of the general ICU system,” said Dr. Eric Jacobsohn, an anesthesiologist and critical care physician.

“It’s an indicator that the rest of the system has failed,” he said of the cancellations.

Surgical slates for non-emergent cardiac procedures set to occur this week also remained in limbo as of late Sunday afternoon.

“Slating is being reviewed over the weekend before any decisions are made related to cases scheduled for next week,” a spokesperson for Shared Health said in a statement on Sunday.

The spokesman was unable to confirm whether scheduled cardiac surgeries would proceed as planned as of 5 p.m. Sunday.

Jacobsohn said it seems health system leaders are playing it “day by day” to determine what human resources are available to staff critical care beds in Winnipeg.

Last week, the Free Press reported that more than one in five emergency and critical-care nursing positions — or 22.7 per cent — in Winnipeg was vacant in October, according to recent data.

Meanwhile, the cancellation of cardiac surgeries amounts to an admission that there are no plans to expand critical care services, given current staffing shortages, and that the health system cannot stretch any further, Jacobsohn said.

“As a clinician caring for patients, and seeing that the system is totally jam packed, it is only reasonable to know from leadership what are our expansion plans, and frankly there are none,” Jacobsohn said.

“The only way that there was breathing room this weekend was ‘Let’s triage through cardiac,’” he said.

According to Shared Health, ongoing issues with the flow of patients in the hospital system and staffing challenges in “some areas” have been worsened by patient demands.

More than five dozen stable, hospital patients have been transferred out of facilities in their home communities to make space for patients requiring specialized or higher acuity care in Winnipeg and in Interlake-Eastern Regional Health Authority.

The cause of the current critical care shortage can also be traced back to the consolidation of the health-care system and the stripping down of services coupled with an “acrimonious” relationship with care providers, Jacobsohn said.

While the pandemic has inflamed existing issues, health-care system leaders have had 20 months to adapt and plan for predictable demand on critical care, he added.

“The critical care community has been on the record for an extended period of time, even before the pandemic, warning the system that you’re ill prepared for even a bad flu season,” Jacobsohn said.

“There is a problem delivering even basic critical care in the city.”

Jacobsohn said during the height of the second pandemic wave, the healthcare system was able to extend critical care to close to 130 ICU patients at once; the number of patients admitted to ICU have hovered under 100 in recent weeks.

Now, concerns are mounting over the ability of the healthcare system to respond to increased demand on critical care related to COVID-19 and influenza through late December and January, Jacobsohn said.

Transparency and accountability also need to be at the forefront in managing critical care demands and in dealing with the province’s massive surgical and diagnostic backlog, he said.

Health Minister Audrey Gordon will reveal the government’s plans to address more than 130,000 surgeries and diagnostic procedures that were delayed due to the pandemic on Wednesday.

“There has to be an accounting of how this happened, of how many people died as a result of the system not being there for them,” Jacobsohn said.

danielle.dasilva@freepress.mb.ca