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A new Same Day Overnight unit has been implemented at McMaster Children’s Hospital to speed up surgeries and get kids home sooner. The team pictured here provides support to patients and their families in the unit.
March 25, 2024

Quicker surgeries, quicker recoveries from home

Broderic Hadath has had four previous surgeries at McMaster Children’s Hospital to repair his clubfoot, a fairly common birth difference. This time, for his fifth surgery, the almost-eight-year-old was able to take advantage of a new process and new space at the hospital to make his stay quicker and easier.

The Same Day Overnight unit is an innovation at McMaster Children’s Hospital (MCH) that allows patients to have less complex surgeries during the day and stay overnight without being formally admitted to the hospital. Patients go home by 7 a.m. and the hospital benefits by reserving inpatient beds for kids who need to be admitted.

Broderic snuggles with MCH mascot Bubbles and gives a thumbs-up before his fifth surgery.

Broderic’s mother Amber Hadath says, “I loved the fact that all paperwork, prescriptions and other details about bringing him home were all given to me that night after surgery. It was really convenient because I could fill out the prescriptions that night, and in the morning, everything was ready. It made the process of leaving the hospital much smoother and less stressful. All we had to do was head out the door and say goodbye to everyone.”

Adding new beds and a new unit

A year ago, in April 2023, MCH added six extra surgical beds in the same day surgery unit and post anesthetic care unit (PACU). Patients located in these two units can access care in the Same Day Overnight program, and staff from those two units provide care. These patients are not formally admitted, but they stay in a surgical bed overnight and are expected to be well enough to go home the following morning after their procedure.

There are existing Same Day Overnight units at two Hamilton Health Sciences adult sites so it made sense to bring this process to the children’s hospital as well. The Same Day Overnight unit is one of the strategies in place to address surgical backlogs due to the pandemic.

Thanks to the new Same Day Overnight unit, MCH has not had to cancel any surgeries so far this fall-winter season.

Carolyn Mirza, clinical manager in Same Day Surgery and PACU.

“After the pandemic, we were facing challenges with bed availability due to increases in respiratory viruses and surgical ramp up,” says Carolyn Mirza, clinical manager in Same Day Surgery and PACU at MCH. “This led to the postponement of scheduled care for patients that required admission.”

This innovative approach has significantly helped in reducing the pressure on patients and their families by decreasing the number of surgical cancellations, and supporting emergency and less complex surgeries. Thanks to the new Same Day Overnight unit, MCH has not had to cancel any surgeries so far this fall-winter season.

Additionally, it has also freed up post-operative beds for patients who genuinely require inpatient admission, and need more time to recover.

A smooth, seamless surgery

Broderic was born with clubfoot and first received care at MCH when he was three weeks old. Clubfoot is a common type of birth difference that affects muscles and bones in the feet. Instead of being straight, a clubfoot points down and turns in. This twisting causes the toes to point toward the opposite leg.

Broderic had many surgeries to help correct his feet, and in February, he had his fifth one. He was released the morning after his surgery, and has been recovering very well.

All smiles here during Broderic’s recovery.

“Everything went according to plan and his surgical team was great,” says Amber. “He is doubled-casted to the knees and using a wheelchair to get around for the next couple of weeks, but he is in high spirits and nothing gets him down.”

Investments lead to better surgical care

Last July, the Ontario government announced a $330 million investment in pediatric health care to reduce wait times and improve care for children and teens across the province. Combined with other investments over the past 18 months, MCH is receiving over $48 million in new, ongoing funding to grow spaces, services and staff.

Thanks to the funding for surgical innovation, MCH was able to create a Same Day Overnight unit that reduces capacity pressures and improves patient flow during surgeries while maintaining top-tier care.

The program accommodates patients who require overnight observation due to pain control or antibiotics. Most importantly, the unit allows patients and families to stay together, which promotes better patient recovery.

“This allows beds on inpatient units to be used for patients whose surgeries are more complex and may require a few days of recovery,” says Mirza. “It also allows for extra bed space when the hospital is busy during influenza season so children get the care they require.”

Instrumental in relieving hospital pressures

Pam Fabian is a registered nurse who has been working in the field for over 30 years and cares for patients in the Same Day Overnight unit.

Pam Fabian is a registered nurse who provides care in the same day overnight unit.

Fabian is responsible for preparing patients and their families for their operating room experience. She collaborates closely with the MCH child life team to provide patients and families with the necessary information and support they need to feel comfortable and confident about their upcoming surgical experience.

She echoes Mirza’s enthusiasm for the impact the unit has made for kids waiting for surgery.

“There have been very few surgical postponements due to beds not being available,” says Fabian. ”The program has been instrumental in relieving pressures on surgical wards at McMaster and other HHS sites, and has also been effective in addressing the surgical backlog that has built up due to the pandemic.”

No cancelled surgeries

The Same Day Overnight unit has been effective in reducing the number of day-of surgery postponements for patients. Previously, patients had to be rescheduled due to a shortage of patient care beds in the hospital.

The unit is fully equipped with health care professionals who specialize in providing round-the-clock care to patients who have undergone surgery. The nursing staff have become more integrated as they work closer with allied health teams and cross-collaborate, providing the necessary care and support not only to patients, but their families as well.

“We have nothing but amazing things to say about the Same Day Overnight staff,” says Amber. “They were always making sure Broderic was comfortable, and always checking up on me to make sure I was doing well too.”