The surgical swap: Clinical integration

It’s 5 p.m. on a damp and dreary evening in March. One by one, a variety of surgeons, radiologists and associated health professionals take their places around the large boardroom table. Although not a foreign environment to the doctors, they would clearly be more at home huddled over an operating table or screening patient images for abnormalities.

Instead, they are making final plans to implement a surgical “swap” between two separate health-care facilities. Unlike the weather outside, the temperature around the table is warm and collegial with a definite “can do” approach to decision-making. The discussion is about the clinical integration project initiated a little over a year ago, by the Mississauga Halton Local Health Integration Network (MH LHIN) to explore opportunities for integration of acute care services at the hospitals within their LHIN.

The first of several integrations will see major vascular and malignant thoracic oncology surgeries, previously provided at both Trillium Health Centre and The Credit Valley Hospital, now provided one at each site. Trillium, home to regional cardiac and neurosurgery programs, will be the site for major vascular surgery, while Credit Valley, which houses the Peel Regional Cancer Program, will be the site for all malignant thoracic oncology surgery.

It means that CVH vascular surgeons will now travel to Trillium Health Centre one day a week to perform their surgery. On the same day, Trillium’s oncology surgeons will move to Credit Valley’s OR suite.

Centralizing these acute care surgeries with a specialized team of surgeons, radiologists, anesthetists and nurses creates a “critical mass” of expertise. The integration project will reduce waiting time for these highly specialized surgeries because of the dedicated operating room time and personnel.

Surgeons’ pick lists are being standardized through mutual agreement among the participating surgeons. Digital images to support decision-making will also be available to surgeons at both sites as well as through remote access. Surgeons will take “call” at both hospitals ensuring consistent and better quality of patient care.

The integration of these two major surgeries is making the best use of Trillium’s and Credit Valley’s health-care dollars and professional expertise.

Centralizing highly specialized surgeries at one location allows the hospitals to focus their expertise to create highly motivated, well educated surgical teams to provide high quality patient care and that bodes well for future recruitment of surgeons and related health-care professionals.

In the words of one of the surgeons involved in the integration project; “We’ll all be better off…and most importantly, the patients will be too.”