Yarmouth County resident Claudette d’Entremont couldn’t have been happier to have her hand surgery completed within hours, allowing her to make her long trip home from Halifax that same day.

“Everything went really smoothly,” says Claudette. “Everything went really fast.”

Thanks to an innovative change made by the QEII Health Sciences Centre’s plastic surgery team, minor hand surgeries like Claudette’s are now being done in an outpatient setting, rather than in the operating room (OR). Not only is the change saving patients time and resulting in faster recoveries, but it is freeing up space in the operating room for more critical surgeries and using health care resources more effectively.

“It is really good news,” says QEII plastic surgeon Dr. Jason Williams. “It’s a nice example of a co-led initiative that has opened the doors to doing things more efficiently.”

When Claudette broke a tiny bone in her left hand in June 2018, she immediately had a cast put on it at the Yarmouth Regional Hospital. But she was told she should get to Halifax as soon as possible where surgeons could put two pins in her hand to ensure it healed properly. The day after her accident she drove to Halifax and the following morning, to her surprise, Dr. Williams operated on her.

“I went in the morning and everything was done by noon,” she says.

Not having to undergo a general anesthetic meant she recovered from the procedure quickly and her risk of side effects was greatly reduced. Having the surgery done in an outpatient setting also meant that she didn’t have to spend extra time and money away from home. After a quick recovery from the surgery, she returned to her job as an elementary school teacher assistant and was able to see the students before their summer break.

“We always want to provide better, more timely care for our patients.”

-Dr. Jason Williams

“The sooner we can get patients back home and to work, the better,” says Jennifer Gallant, health services manager for outpatient care at the QEII’s Halifax Infirmary.

A 2017 study done by Dr. Joshua Gillis, then a plastic surgery resident at the QEII, and Dr. Williams, found it would be far more effective, and cost as much as 400 per cent less, to complete plastic surgery cases involving the hand in an outpatient setting. Dr. Williams set out to find a way to make that happen.

He went to Jennifer with his idea and she was immediately on board. When a portable X-ray machine became available from an operating room, Jennifer found Dr. Williams and his team a room in the QEII’s minor procedures area. Since doing the first procedure outside the operating room in September 2017, Dr. Williams and his team now do as many as five hand and finger fracture surgeries per week in their dedicated room. Instead of requiring up to seven healthcare professionals to facilitate the procedure in the operating room, Dr. Williams and a resident can now operate alone by giving patients a local anesthetic.

“It takes a load off the OR, freeing up surgery times for people who need more serious surgeries,” says Dr. Williams.

For patients, it means no longer having to wait four or five days for operating room space to become available. Dr. Williams now often sees a patient and that same day operates on their hand or finger. Having the ease and flexibility of working outside the operating room means that patients can be treated sooner, leading to faster healing.

“We always want to provide better, more timely care for our patients,” says Dr. Williams.