Provinces

The Canadian Orthopaedic Association (COA) is proud to count on provincial orthopaedic associations and institutions as their partners. Over the last two years, COA conducted a national virtual tour to 10 provinces and engaged with over 300 surgeons. Members of the orthopaedic community met to represent their province’s current needs, as a result of the pandemic.

ALBERTA

Coming soon.

BRITISH COLUMBIA

It has been just over one year since the BCOA began an extremely active campaign to bring awareness to British Columbia’s citizens, media and the B.C. Government on the significant wait times for orthopaedic surgeries in the province. While we have had some success securing meetings with the ministry of health, there are still unacceptable patient wait times and few solutions to improve orthopaedic patient care in the province including:

  • Up to more than two years wait for knee, joint and hip surgeries in some areas of B.C. with people becoming depressed and addicted to opioids and facing loss of work while they wait – major physical and mental health deterioration.
  • 2000 people on a waitlist for orthopaedic surgery in Prince George. Major backlog for surgeries in Northern B.C.
  • An estimated one million British Columbians waiting to see a Specialist, emphasizing the importance of global system investment and change.

What can government do to push change forward change on a provincial level?

  • Improvements to Health Care Workforce and Work Environment for all Health Care Workers – Fair workload, Safe workplace, mental health support, validation.
  • Decisions on healthcare funding need to be evidence based – not based on politics. HCW need a seat at the table. There is no place for a to down approach that is seen across many provinces.
  • Research & Evaluation (DATA) needed to tell us how to improve delivery of health care. We need leadership collecting workforce data. Need research to inform solutions.
  • Test different models of care. Share results with other hospitals. Collaborate.

MANITOBA

Overview of Orthopaedic care in the province, current issues that need to be solved/addressed.

  • Specialist Orthopedic Care in Manitoba is mainly centred in Winnipeg with 2 rural centers providing general orthopedic care
  • Access to orthopedic referral is above recommended wait times in all areas. Total joint replacement consult is 6-12 months from referral. All other specialities have 4-24 month long waits.
  • Access to orthopedic surgery is above recommended wait times in all areas. Total joint replacement surgical wait times are 6-18months from time of consultation. All other specialities have 6-24 month long waits for surgical care from consultation.
  • As a result of the long wait times and insufficient human resources, Manitoba has developed Out of Province options for Spine and Hip/Knee Arthroplasty. Options for other orthopedic subspecialties are being developed.

What can government do to push change forward change on a provincial level?

  • Increase human resources to improve access to care including orthopedic surgeons, OR nursing, ward nursing, health care aides, extended health care providers
  • Decant day surgery procedures to private operating rooms to increase throughput

NEW BRUNSWICK

  • Anesthesia shortages causing bottlenecks for surgery and operating room time.
  • Resource disparity between hospital systems. No effective allocation or shared resources.
  • Job scarcity. Early career surgeons are underemployed and leaving the province in search of opportunity.

NEWFOUNDLAND AND LABRADOR

  • Access to care disparity, growing patient waitlist especially for hip fractures from aging population.
  • Orthopaedic departments blamed for inefficiencies on ground level. • Nursing shortages and burnout.

NOVA SCOTIA

  • Lack of primary care physicians poses logistical and ethical challenges later when addressing specific health issues related to orthopaedic care.
  • Early career surgeons not able to train effectively, make connections and collaborations from being in virtual environment.
  • Care team fatigue.

ONTARIO

  • Job scarcity. Surgeons are foregoing retirement, creating job shortages. • Disparity in resource allocation, both regionally and specific to specialty.
  • Orthopaedics deemed a low priority.
  • Nursing and anesthesia shortages.

PRINCE EDWARD ISLAND

  • Allocation and prioritization of resources.
  • Orthopaedic care considered low priority.

QUEBEC

  • Prioritization of orthopaedic procedures, while breaking perception that these are lifestyle surgery or elective (optional, by choice) procedures.
  • Critical shortage of nurses and ancillary staff, impedes hospitals to perform outpatient orthopaedics.
  • Surgeons have successful models that improve efficiencies, but many are not implemented by administration.

SASKATCHEWAN

  • Strained healthcare practitioners during COVID-19.
  • General discouragement and confusion how to advocate for better access to care in orthopaedics.
  • Nursing shortages, both on the floor and operating rooms.