Australia’s two most populous states, New South Wales and Victoria, have announced separate measures to tackle lengthy elective surgery waiting lists.
In Victoria, the government has tabled two initiatives with evocative names – ‘Super Saturdays’ and ‘HIT list’ surgery – to help clear backlogs. In NSW, it’s hoped a plan to make knee and hip replacement surgeries day procedures will achieve similar results.
‘Super Saturdays’ and ‘HIT lists’
The term ‘Super Saturday’ is one most would probably associate with sports. In the health sense, the concept is quite similar and forms the basis of the Victorian government’s new plan.
Released last week, the government’s ‘Planned Surgery Reform Blueprint’ uses the term to describe a day of high intensity theatre. This gives rise to the term ‘HIT lists’, focusing on performing a higher number of surgeries on a single day.
The concept is explained in the blueprint, with a narrower focus producing greater efficiency. “Typically, HIT lists focus on a single surgical discipline or set of procedures (such as cataract surgery or hip replacements).
But the Victorian blueprint says HIT list surgery does not have to be limited to a single day. The government has also introduced the concept of the ‘Perfect Week’. In fact, this idea has already been tested successfully.
In a low activity period at the start of 2023, Austin Health piloted a program called ‘Bone and Joint Week’. The goal of this bold undertaking was to complete 10 per cent of its usual yearly activity in a single week. That took in 62 orthopaedic patients: 41 joint replacements and 21 other procedures.
The trial was declared a success, There were no adverse events and both staff and patients reported high satisfaction levels with the outcomes.
All in a day’s work
The plan in NSW entails single days, with the focus on patients spending their first night after surgery at home. A state surgical taskforce in May identified a number of procedures that could be done safely that way.
As a result, procedures such as hernia repair, gall bladder removal and deviated septum surgery are same-day affairs at a small number of hospitals. The taskforce is now looking at expanding this to include joint surgeries, such as knee and hip replacements.
The taskforce is also looking at extending the trial to take in hospitals across the state. Taskforce co-chair Professor Neil Merrett said: “What we’re doing is trying to decrease the amount of time patients are in hospital.” This could be achieved, he said, “by targeting those groups of patients that we’re certain are in the best possible shape for it.”
Medical staff will still be able to make judgement calls on whether patients need to remain in hospital. Dr Andrew Ellis, from the Australian Orthopaedic Association, acknowledged that same-day joint replacement was not suitable in every case. But, he said, in Australia it is the “way of the future”.
Surgery on the move
Victroria’s blueprint also flags the possibility of patients being ‘shipped’ to regional hospitals for some surgeries. It could result in people from outer Melbourne sent to neighbouring regional hospitals for common procedures. This would help make the most of any capacity in the system.
The Victorian plan was hailed by Dr Patrick Lo, Victorian chair of the Royal Australasian College of Surgeons.
It could be some time before the extent of success of the two state plans is known. Regardless, any significant reduction in surgery wait times will be welcomed, especially by patients.
Have you had hip or knee surgery? What do you think of it becoming a day procedure? Why not share your thoughts in the comments section below?
Also read: Who are you? Mysterious moments before and after surgery
