Hospitals in Australia Are Struggling to Increase Surgical Volumes Post-COVID

Whitepaper

15 Sept

Introduction

The global COVID-19 pandemic has affected almost every industry, including healthcare. Hospitals, at the forefront of this pandemic, had to manage a tremendous load on staff, procedures and materials to try minimise outbreaks of infection at their facilities. Consequently, patient throughput dropped – and many hospitals around the world are still struggling due to lower surgical volumes. This whitepaper focuses on the impact of COVID-19 on hospitals in Australia and their delayed return to normal surgical volumes. We'll take a deep dive into its effect on staffing, staff burnout, profit, surgical logistics, and equipment.

COVID’s Effect on Surgical Volumes

In Australia, hospitals have experienced a significant reduction in surgical volumes since the pandemic began. One key reason for this is the postponement of elective surgeries to preserve hospital resources and reduce the spread of the virus. However, even after the initial wave subsided, there has not been a recovery of surgical volumes. According to the Australian Institute of Health and Welfare, there was a decline of 7% in the number of elective surgeries performed in 2020 when compared to the previous year. Volumes in 2022 are still 2.2% below pre-COVID volumes.

Furthermore, emergency surgeries have also seen a decrease, with fewer people seeking medical help due to fear of contracting the virus. Despite the lifting of pandemic restrictions, surgical volumes have not returned to baseline, or seen growth. This is despite increased demand for surgery across Australia over the past decade, due to factors such as an aging population and improved access to healthcare services. This decline in surgical volumes has had a significant impact on the financial sustainability of hospitals.

Nurse Shortages

Nurses make up an essential part of any healthcare team, providing critical advice and support to patients. In Australia, however, there is a growing concern over the shortage of nurses. According to University of Technology Sydney, Australia will face a shortfall of 85,000 nurses by 2023, and an alarming 123,000 by 2030 if steps are not taken to address the following issues: an ageing workforce, a significant proportion of nurses reaching retirement age, and an insufficient number of new graduates to replace them. The report also points out that regional and rural areas are particularly affected, with these areas often struggling to attract and retain nursing staff due to geographical isolation, limited professional development opportunities, and lower wages compared to metropolitan areas. This shortage is not only detrimental to the quality of care patients receive but also increases the workload and stress levels of existing nursing staff, which could lead to burnout and exacerbate the issue further.

The lack of staff within Aged Care Settings threatens patient safety and places an excessive burden on those nurses who are still working. In response, the Federal Government has released a new regulation that requires aged care facilities to provide 24-hour nursing services for all residents. While a positive step for aged care, this exacerbates the nurse shortages in other critical areas such as surgical hospitals, creating a ripple effect with potential for dire consequences. This predicament has led to increased workloads for existing surgical nurses, resulting in longer working hours and increased patient-to-nurse ratios. This heightened pressure threatens the quality of patient care, increases the risk of burnout amongst nursing staff, and may lead to heightened attrition rates. Reduced staffing levels also impede the efficient operation of surgical units, causing delays in surgical procedures and potentially compromising patient outcomes. There's a pressing need for interventions to address these challenges and maintain the high standards of care that Australian surgical hospitals are renowned for.

Staff Burnout

The COVID-19 pandemic has led to a rise in staff burnout in hospitals. Healthcare workers are dealing with a higher volume of patients, often working extended hours in difficult conditions while also dealing with the fear of contracting the virus. This increased workload, coupled with a lack of sufficient support and resources, has led to a sharp increase in staff burnout levels. In Australia, a survey by the Australian Nursing and Midwifery Federation found that 54% of nurses reported feeling burnt out due to the pandemic.

The impact of staff burnout cannot be overstated. Burnt-out healthcare workers are more likely to make mistakes, experience mental health issues, and, in extreme cases, may quit their jobs altogether. This can have a severe impact on the quality of care provided by hospitals, leading to a vicious cycle of staff burnout, decreased quality of care, and lower surgical volumes. The pandemic has caused significant emotional, physical, and financial strain on healthcare workers. They have had to adapt quickly to the changing environment while still providing top-notch care to patients. This has caused a significant increase in anxiety and stress levels among hospital staff.

After two years of managing a pandemic, staff members are exhausted. The decrease in surgical volumes has given them little time to recover and they are struggling in their work. This affects their health, their workplace performance, and the quality of care they provide to patients. Increased absenteeism makes it more difficult to ensure surgical teams have the correct skill mix and experience for moderate and more complex surgery.

Effect on Profit

The decrease in surgical volumes has significantly affected the revenue of many hospitals in Australia. Hospitals rely heavily on surgical volumes to generate revenue to fund their operations. The pandemic forced many hospitals to cancel elective surgeries, leading to a drop in financial resources. It is one of the reasons some hospitals reduced or stopped hiring new staff.

Furthermore, staff burnout can result in increased absenteeism levels, which, in turn, increases the cost of hiring temporary staff to fill in the gaps. This can have a further impact on the financial sustainability of hospitals, as they struggle to meet staffing costs while also maintaining the quality of care provided to patients.

Decreased efficiency in work due to sub-optimal skill and experience in teams drives up costs - without a corresponding increase in revenue. Impaired efficiency is another barrier to returning surgical volumes to pre-pandemic levels, and to growing volumes.

Impact of Equipment

The pandemic has impacted medical equipment production and distribution and has caused a shortage of supplies in some hospitals. Lead times for ordering have increased. Hospitals in Australia are struggling to get access to the necessary equipment to carry out surgeries. It can cause significant delays in surgical procedures and impact the quality of care provided to patients. Cancellation of booked surgery can occur, which is expensive to reschedule.

Surgical Logistics

Hospitals in Australia restructured their surgical procedures during the pandemic to comply with COVID-19 protocols. They reduced the number of surgeries performed daily, leading to a backlog of cases that could take months or years to recover. In some cases, patients who urgently need surgery are being turned away due to inadequate resources. This could increase patient mortality rates, lengthen hospital stays, and introduce new medical conditions into patients due to delayed care.

Conclusion

The COVID-19 pandemic has significantly impacted surgical volumes and healthcare delivery in Australia. The demand exists for increased surgical volumes, however the current healthcare system is struggling to accommodate this demand due to staffing, efficiency and systemic constraints.

Hospital staff members are struggling with burnout, and hospitals are facing a decline in revenue. Further, the shortage of medical equipment can not only delay surgical procedures but also affect the quality of care provided to patients. The logjam of procedures could take years to clear, and that means that patients would have to wait longer for elective procedures or even urgent ones, thus putting their lives at risk. It is essential to implement innovative strategies to improve the situation, such as investing in technology to improve efficiency, risk and working conditions. By doing so, hospitals in Australia can keep up with surgical volumes, provide better care for patients, and restore revenue lost during the pandemic.