Task force pushes cutting some rural departments

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This article was published 19/12/2017 (2466 days ago), so information in it may no longer be current.

The Manitoba government should consider closing rural emergency departments that aren’t treating a substantial amount of patients needing immediate or near-immediate care such as cardiac arrest and life- or limb-threatening conditions, a new study says.

It is one of several findings put forward by the wait times reduction task force in its overdue final report, released by the province Wednesday.

The task force recommends the possible closure of any rural emergency department that treats one or less patient each year who qualifies as level one on the Canadian triage acuity scale, or 200 or less patients who qualify as level two.

The triage scale ranks all emergency visits on a scale of one to five: one being those who’ve suffered cardiac arrest or multi-system trauma; five being those who use the ER for problems more appropriate for a walk-in clinic.

That people would go to the ER for things such as medication refills is not surprising, the report says: “For many people, our health-care system is a confusing array of disparate services that they never think about until a sudden health problem occurs. When it does, they gravitate to the ED (emergency department).”

That’s in keeping with the task force’s findings. Through multiple community consultations, it found while urban concerns were focused largely on wait times, in rural communities that concern was largely about access: would there be an ER? Was the communication about when it was open clear? Was the ambulance service timely?

“They need reassurance that everything is going to be OK,” said Dr. Alecs Chochinov, co-chairman of the task force’s emergency department wait times reduction committee.

The task force recommends Shared Health Services, in conjunction with the regional health authorities, co-ordinate an emergency department service plan that integrates existing regional hubs — 10 of the larger rural EDs — with urgent care centres, primary care and EMS.

When looking at which EDs should remain, the report notes the government should evaluate those delivering round-the-clock, consistent care and whether there is another ED within 60 minutes’ drive.

“I suspect the individual RHAs probably have some fairly concrete thoughts about how emergency services should be reorganized within their region,” said Dr. Brock Wright, chief executive officer of Shared Health.

It’s not a good plan, argued NDP health critic Andrew Swan.

“The government has effectively said that they think it’s terrible if an emergency room is not open 24/7, so they’ll just close them,” he said.

Health Minister Kelvin Goertzen did not attend the news conference Wednesday, nor was he available to speak with reporters. He’s expected to address the report today.

jane.gerster@freepress.mb.ca