Alberta pilot aims to reduce surgery backlog, 'enhance sustainability' of anesthesia services

In an effort to help reduce surgery backlogs and increasing workloads for anesthesiologists, Alberta Health Services is piloting a new anesthesia care team model for cataract procedures.

Before the pilot, one anesthesiologist, often assisted by a respiratory therapist, would care for one patient during cataract surgery.

The new team would have one anesthesiologist supervise two procedures, each supported by a registered respiratory therapist, with a level two classification and additional specialty training.

Currently, AHS is piloting the project at two sites, one in Edmonton and another in Calgary, with plans to consider additional sites as the pilot outcomes are assessed.

The changes will be tested until the end of March next year, with ongoing evaluation and opportunities for feedback, said Kerry Williamson, AHS spokesperson.

"Following completion of this pilot project, for cataract surgery, various stakeholders will review the outcomes," Williamson added in a statement to CTV News Edmonton.

'SUPPORT SURGICAL RECOVERY FROM THE PANDEMIC'

Williamson said should the pilot be successful, AHS would "perhaps" examine other ways to implement the alternative model of care for other procedures and venues.

"AHS is undertaking a number of initiatives to enhance the sustainability of anesthesia services," Williamson said.

"The ACT pilot is one of those initiatives and will support surgical recovery from the pandemic, as well as increase capacity to complete additional surgeries with the goal of reducing wait times."

According to Alberta Health's wait times reporting, as of February 2022, the average wait time for cataract surgery for a patient's first eye is slightly longer than four months.

The overall surgery backlog stood at 81,600 in December 2021, the last publicly available figure. That number stood at 68,000 procedures before the pandemic, which has been rising and falling as waves of COVID-19 swept through the province.

'PHYSICIAN EXTENDER'

Dr. Dolores McKeen, Canadian Anesthesiologist's Society president, said several provinces use this care model, including Ontario, B.C., Nova Scotia, and Manitoba.

"By having an anesthesia care team, it allows us to have, sort of a physician extender to be able to take on some of those roles," McKeen said. "It very much allows us to expand our footprint."

Dr. Kevin Gregg, the president-elect of the Alberta Medical Association anesthesia section, said the pilot could help free up at least one to two anesthesiologists per day in Edmonton and Calgary.

"If we can make this work, you've now freed up an anesthesiologist who can be doing different surgeries that day," Gregg said.

"It will help a little bit," Gregg said. "It's a start. There's not going to be a magic bullet that fixes everything."

McKeen says Canada is experiencing a "critical" shortage of anesthesiologists as the number of trained individuals struggles to keep pace with retiring practitioners and the demand for procedures increases.

"Alberta, probably, is one of the provinces we hear is having more challenges than some of the others in Canada," she said.

Leanne Alfaro, Health Sciences Association of Alberta vice president, told CTV News Edmonton that respiratory therapists were part of the planning process for the pilot and are ready to help play their role in reducing surgical backlogs.

"These dedicated, stoic and resilient experts are taking on even more work at the same time the current government is asking them to take wage rollbacks," Alfaro said.

"If the current government is truly interested in overcoming the surgical backlogs it has created, it would be funding and supporting the staff needed to run the operating rooms sitting empty in the public system," she added. "Instead, it is giving public funds to private operators."

With files from CTV News Edmonton's Kyra Markov and The Canadian Press