The impact of delayed nonurgent surgery during the COVID-19 pandemic on surgeons in Alberta: a qualitative interview study

Abstract

Background: During the COVID-19 pandemic, nonurgent surgeries were delayed to preserve capacity for patients admitted with COVID-19; surgeons were challenged personally and professionally during this time. We aimed to describe the impact of delays to nonurgent surgeries during the COVID-19 pandemic from the surgeons’ perspective in Alberta. Methods: We conducted an interpretive description qualitative study in Alberta from January to March 2022. We recruited adult and pediatric surgeons via social media and through personal contacts from our research network. Semistructured interviews were conducted via Zoom, and we analyzed the data via inductive thematic analysis to identify relevant themes and subthemes related to the impact of delaying nonurgent surgery on surgeons and their provision of surgical care. Results: We conducted 12 interviews with 9 adult surgeons and 3 pediatric surgeons. Six themes were identified: accelerator for a surgical care crisis, health system inequity, system-level management of disruptions in surgical services, professional and interprofessional impact, personal impact, and pragmatic adaptation to health system strain. Participants also identified strategies to mitigate the challenges experienced due to nonurgent surgical delays during the COVID-19 pandemic (i.e., additional operating time, surgical process reviews to reduce inefficiencies, and advocacy for sustained funding of hospital beds, human resources and community-based postoperative care). Interpretation: Our study describes the impacts and challenges experienced by adult and pediatric surgeons of delayed nonurgent surgeries because of the COVID-19 pandemic response. Surgeons identified potential health system–, hospital- and physician-level strategies to minimize future impacts on patients from delays of nonurgent surgery.

Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan

“…7,8 The distress of delaying nonurgent surgeries extended to surgeons who worried about their patients' health, had to shift responsibilities away from surgery to help with the COVID-19 response, the consequences of which extended into their personal lives. 9 There were also wider impacts of the COVID-19 response; it has been reported that there has been an excessive death rate (beyond COVID-19 cases) in several health conditions some of which may be directly related to delayed surgeries, [10][11][12] and fewer patients sought medical care for fear of contracting COVID-19 in healthcare settings which is likely to have a trickle-down effect for some time. 13,14 Despite all that is now known about the impact of the COVID-19 response, during the height of COVID-19 little evidence was available to support decision-making.…”