The Heart and Lung Clinic at Oslo University Hospital has established a “heart bridge” to St. Olav’s Hospital in Trondheim for patients who are going to change heart valves or operate on the main artery.
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In an earlier version, VG wrote that 20 patients from OUS had surgery at St. Olav’s, but this is incorrect. See extended correction at the bottom of the case.
As a result of the pandemic, the ward’s intensive care unit has been busy treating seriously ill covid patients at the Emergency Department.
OUS has therefore requested that colleagues at St. Olav’s hospital in Trondheim receive and operate on 20 heart patients. So far, one patient has undergone surgery.
– This is a group of patients who can wait for surgery for several months. We believe that there is now too long a waiting time for some patients, therefore we have entered into a collaboration with St. Olav’s hospital, says head of department Arnt E. Fiane at the Department of Thoracic Surgery, Oslo University Hospital.
An extra trip for the patients can be experienced as a burden.
– This is not something you want. But we use the capacity that is possible in the dilemmas that arise, says Fiane.
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Grethe Aasved, CEO of St. Olav’s hospital, writes in an e-mail to VG that since early spring 2021 they have had an agreement with OUS to contribute with planned heart operations.
– This is due to the fact that OUS has challenges with capacity. So far this year, St. Olav’s hospital has operated on one patient from OUS.
She says that the agreement was put on hold when St. Olav’s hospital went into yellow emergency on November 2 due to a full hospital.
– There has always been close contact between the hospitals, and St. Olav’s hospital is positive to continue the agreement when the situation allows it, says Aasved.
–Intensivkompetanse
The intensive care nurses at the Thoracic Surgery Department are now contributing to the Emergency Department, where the intensive care unit treats five covid patients on an ECMO machine. It is a heart / lung machine that connects to the body’s large blood vessels. The machine relieves the organs and gives them time to recover. The treatment is used on the sickest covid patients and is very resource-intensive.
Intensive care nurses in particular staff these beds.
– This “drainage” of specialist expertise means that we in the cardiac surgery department must take down our business. It has persisted for a while and it provides increasing waiting time for our patients. Fortunately, I can not see that we have had deaths on the waiting lists. We follow this very closely, says Fiane.
The ward has experienced a backlog of patients waiting for heart surgery and major aortic surgery.
– It is of course very important that these patient groups do not experience further loss of prognosis due to increased waiting times. The situation has triggered some medical dilemmas in relation to prioritizing total resources, says Fiane.
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– Is about total capacity
Department head Fiane believes the situation is about Oslo University Hospital’s total capacity.
– This leads to some prioritization discussions. It is an indicator of lack of resources in relation to the situation the hospital is in. We as managers are very aware of the issues and it is important that we make this visible to the granting authorities. It’s not just about money. It is also about knowledge and competence, says Fiane.
The shortage of intensive care nurses has been communicated from both the hospitals and the unions for a long time. It has also been pointed out by, among others, the Office of the Auditor General.
– Immediate help always comes first. Some conditions are urgent, while others can wait up to several months. We want to avoid the patient getting a prognosis loss. Therefore, we have chosen the solution of flying them to St. Olav. There they have capacity now, but there may also be a situation where they have to send some patients to us. It is an assessment in relation to competence and national health resources. The pandemic fluctuates. It requires good dialogue between the specialist departments.
Correction: In an earlier version of this case, VG head of department Arnt Fiane at the Department of Thoracic Surgery at OUS quoted that 20 heart patients had been sent to St. Olav’s hospital in Trondheim for surgery in the last two weeks. This is wrong. The correct thing is that one patient from OUS has had surgery at St. Olav’s so far this year, but that OUS has asked to send 20 patients for surgery.
As a result, the title has also been changed from “OUS: Sending heart patients to surgery in Trondheim” to “OUS wants to send heart patients to surgery in Trondheim”.
VG also quoted department head Arnt Fiane that St. Olavs “currently has capacity”, but this quote has been removed, since the hospital has been on yellow alert as a result of a full hospital since 2 November.
A comment from the CEO of St. Olav’s hospital has also been added.
The changes were made on 13.11.21 at 14.11.
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