The long and short of disruptions in surgical services due to the COVID‑19 response: the impact and path forward
Hard decisions were made about healthcare delivery in response to COVID, largely without evidence due to the unprecedented and rapidly evolving nature of the pandemic. Non-urgent surgeries were delayed to create space for the surge of COVID patients. The implications of these decisions are beginning to become clear and are widespread. Decision-makers want and need evidence to decide how to redesign surgical services to manage the backlog of surgical cases and to plan for additional waves of COVID‑19 and subsequent pandemics. We will generate evidence to support decisions about surgical services during COVID and other pandemics by answering 3 questions: 1) How do pandemics affect surgical care delivery? We will conduct an environmental scan of major surgical centres nationally to understand surgical service reallocated across Canada. 2) What is the impact of delaying non-urgent surgeries on surgery patients, healthcare providers and the healthcare system? We will extend our current work examining the impact of the first wave of COVID‑19 on surgical care using administrative/clinical databases to include the subsequent waves, and we will conduct interviews with patients whose scheduled surgery were delayed and their healthcare providers to understand the impact of delaying non-urgent surgeries. 3) How can we design surgical services in the future? Canadian decision-makers will use our findings to discuss and begin to establish guidance for surgical service provision during COVID and future pandemics, including managing a backlog of surgeries using a World Cafe. We have strategically assembled a national team of researchers, clinicians, and decision-makers (knowledge users) to generate user-driven evidence to inform the provision of surgical care during COVID‑19 and future public health emergencies. Our findings will directly influence a redesign of surgical service delivery within our “new normal” healthcare system and for the future.