Major surgery for city hospitals

Hey there, time traveller!
This article was published 06/04/2017 (2774 days ago), so information in it may no longer be current.

Three Winnipeg hospital emergency departments will be shut down in the next two years as part of sweeping health-system changes designed to reduce wait times and beef up care for the elderly.

At a news conference Friday, the Winnipeg Regional Health Authority and Manitoba Health Minister Kelvin Goertzen said change is needed to improve service and increase efficiency.

Neither the WRHA nor the minister could place a cost on the changes, saying that detailed plans are still being worked out. The WRHA said in the long run savings should be achieved through greater streamlining and efficiencies.

Health Sciences Centre, St. Boniface General Hospital and Grace Hospital will continue to offer full surgical and ER services. Seven Oaks, Victoria and Concordia will have different roles in the system.

While the changes will be implemented over a 24-month period, Winnipeggers will start to see the plan being implemented in the next six months as the emergency department at Victoria transitions to an urgent-care centre to handle serious, but not life-threatening cases.

Goertzen said the health-care system in Winnipeg is “broken” and the measures being implemented are “evidence based” and follow consultations with hundreds of stakeholders.

“Doing nothing was not an option,” he said. “Things were not going to improve if we didn’t change things. We just couldn’t just continue to pour money into a system that wasn’t working.”

The changes are based on recommendations from Nova Scotia consultant David Peachey, who issued a 233-page report to the government in February. His report was commissioned by the previous NDP government in 2015.

“Cities such as Vancouver, Calgary and Ottawa have fewer emergency departments per capita, yet have shorter wait times than Winnipeg. Clearly, more is not better,” Peachey said. “Three emergency departments will allow the WRHA to provide more focused and specialized care.”

The report, titled Provincial Clinical and Preventive Services Planning for Manitoba, Doing Things Differently and Better, proposed that the remaining city hospitals be designated for convalescence and rehabilitation services.

With all city hospitals possessing critical-care units and emergency departments, “the system has evolved into an expensive, unsustainable model that is failing patients and potentially could result in harm,” the report said. “The majority of patients in medical beds in the WRHA do not require this level of care, and in fact are at the level of convalescence or simply waiting for a non-hospital option.”

WRHA board chairwoman Karen Dunlop warned there would be “disruptions” as the changes are implemented. But she said her board, appointed by the Progressive Conservative government is, unanimously, behind the plan.

“It improves quality of care, strengthens the system, improves patient services and lowers cost,” she said.

The WRHA will be launching a public education campaign in the coming days to explain the changes.

It has also created a new website to provide information: healingourhealthsystem.ca.

Winnipeggers suffer some of the longest waits for emergency-room service and certain critical-health procedures in the country, and various attempts over the years to improve service within the existing system have largely failed.

It has been a case of trying to do too much at too many hospitals, experts say. Manitoba can’t afford to place enough specialists, technicians and critical diagnostic equipment in all six facilities around the clock.

 

 

WRHA president and CEO Milton Sussman said patients currently wait too long for care, stay in hospital too long and often have to be taken to multiple centres for tests and treatment.

“There are too many transfers of our sickest patients between facilities,” he said.

Getting tests results on time and seeing specialists can be difficult, he said. “The equipment and the experts are spread too thinly across our system, which results in long wait times.”

And there is a growing need for more elder care, home care and mental-health services.

Medical experts say the consolidation of services has already begun. Cardiac emergencies are sent to St. Boniface and Health Sciences Centre handles trauma cases; community hospital ERs are already bypassed most of the time in those situations.

It’s estimated that 85 to 90 per cent of medical “emergencies” are less serious and can be dealt with at urgent-care facilities. The city will have two — at Victoria and Seven Oaks hospitals. The existing urgent-care clinic at Misericordia Health Centre will be shut down and the space used for intravenous therapy.

Winnipeggers who fear their lives or those of family members are in danger should call 911 and they will be transported to the appropriate facility, reporters were told Friday.

While there was never any doubt that the province’s two largest hospitals — St. Boniface and HSC — would continue as full-service facilities with emergency departments, there was a choice to be made for a third from among the four community hospitals.

Grace was chosen for several reasons. For one, it has an MRI onsite and its emergency department is currently undergoing a major redevelopment that will be completed next spring.

Dr. Brock Wright, the WRHA’s chief medical officer, said the hospital already has the best ability to take on increased surgical capacity, and its internal medicine department is also the largest of the community hospitals.

The three hospitals losing ERs will take on new responsibilities relating to an aging population. And, while few details were provided Friday, the WRHA said it will be expanding home-care services to allow more than 1,200 patients each year to “transition home for recovery” after they’ve been treated to take pressure off the hospital system.

 

 

The WRHA said the program will also support “high-risk patients” in the community who would otherwise rely on emergency departments for care.

“We will better support those people and their families so they can be safe and as independent as possible in the community for as long as possible,” said Lori Lamont, the WRHA’s chief nursing officer

If wait times in emergency departments and other key services improve, then the changes will have proven to be successful. But that won’t be clear for several years.

The WRHA couldn’t say Friday how much it will cost to revamp the system. Instead, officials insisted that a more efficient and streamlined system was bound to be less costly.

“Ultimately, we do think… by having our system more effective and efficient it will lower our costs,” Sussman said. “We believe this will, at its end, save us a significant amount of dollars.”

It was evident Friday that the changes are still very much a work in progress, with WRHA officials admitting that three months of detailed planning remain before any changes will be implemented.

They said that apart from the redevelopment of the emergency department at Grace, which is already well underway, there should be minimal capital costs to cover.

Lamont said in order to accommodate the changes, some medical staff will have to relocate.

“At this point, we don’t anticipate any significant job loss as a result of this,” she said Friday. “This is about moving services and aligning services in a better way. It’s not about cutting front-line staff.”

larry.kusch@freepress.mb.ca

Peachey report