The COVID-19 pandemic dictated that difficult decisions be made to postpone thousands of scheduled surgeries across the country. These decisions were taken to limit contact and reduce the possible spread of COVID-19 as well as ensure capacity to respond to the prospect of massive spikes in COVID-19 hospitalizations.
The scope of the cancellations has been daunting, with as many as 400,000 elective surgeries deferred by mid-June 2020 with experts estimating then that each week would see nearly 33,000 additional cancellations.1
A Canadian Medical Association study released in the fall of 2020 identified the most common procedures delayed as being:2
Although hospitals and health regions across the country ramped up efforts to address the backlog of postponed surgeries, these deferred procedures caused significant anxiety, inconvenience and hardship to patients and their families. The pandemic presented further complications by isolating patients from usual support structures. To reduce COVID-19 transmission risk, patients were forced to advocate for themselves without caregivers and loved ones. There is significant supporting evidence for the important role that family caregivers play in improving patient care, safety and outcomes, and the Canadian Foundation for Healthcare Improvement has released policy guidance for their re-integration.
Surgical cancellations have also led to adverse outcomes and very difficult situations for many patients including delayed diagnoses. Both patients and providers now find themselves having to make increasingly tough decisions regarding care. Yet, for other patients, some experts are asking how many of the above-mentioned tests and procedures are truly necessary.
Canadian and International data indicate that nearly 30% of tests, treatments, and procedures routinely conducted show no benefit to patient outcomes. Even though medical professionals have redoubled efforts to clear surgical backlogs, a full return to pre-pandemic processes has not been possible in all parts of the country. Further, the Canadian healthcare system has long been plagued by queues and wait-times. With these challenges in mind, Choosing Wisely Canada is urging all levels of government and healthcare systems to look more closely at unnecessary medical tests, particularly in several key areas.
Since 2014, Choosing Wisely Canada (CWC) has worked with clinician groups and specialty societies to identify opportunities for streamlining medical practices and reduce low-value care. CWC collaborates with professional societies, medical schools, patient groups, and providers to promote evidence-based medical practices and significantly reduce the use of inefficient tests and procedures. While incredibly challenging, the COVID-19 pandemic and ensuing disruptions in healthcare also present an opportunity to bring long-lasting and sustainable change to the health care system.
Choosing Wisely Canada contends3 that implementing changes in five specific policy ideas will greatly simplify processes and save time:
Expanding on these ideas through partnerships with policymakers, health providers, and patient groups will strengthen the Canadian healthcare system’s ability to provide timely, accessible, and evidence-based care. More information on the policy ideas from Choosing Wisely Canada can be found in their report.
PUBLISHED
February 10, 2021
FOR FURTHER INFORMATION
Siri Chunduri
Policy and Research Analyst
schunduri@healthcarecan.ca
Jonathan Mitchell
Vice President – Research and Policy
jmitchell@healthcarecan.ca
