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Campaign just one tool

I must take issue with Dr. Drummond (WRHA gets it wrong again, Letters, July 9) on the WRHA's recent communication strategy to reduce the use of emergency departments.

It is well-known that extended wait times in ERs are merely a symptom of wider issues throughout the system and that there is no single solution to reduce these times. It will take a collective and well-researched set of actions over a period of time to make a long-term, sustainable difference. The communication strategy is but one tool being used in this regard.

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Drummond is correct when he suggests that redirecting less urgent patients, by itself, will not reduce wait times. However, we never said it would. The campaign is one piece of our overall patient-flow strategic plan, which includes a host of other measures to address patient-flow challenges, including measures aimed at reducing length of stay in hospital for patients not requiring acute care.

The campaign is also much more about building awareness of alternatives the public can consider other than going to an ER, awareness our research suggests is very low. In this regard, while the campaign is about redirecting less urgent patients from ERs, it's also about helping the public navigate the myriad of service options so they can find the right care, in the right place, at the right time.

As a management professor and management consultant for over 35 years, I am in a good position to compare the system-change methods being used within the WRHA in redesigning the patient-flow system. What is being done at the WRHA in lean management, patient-flow analysis and system redesign would be comparable -- and in some cases superior -- to what I have experienced in industry.



Winnipeg Regional Health Authority


While I agree with Dr. Alan Drummond that insufficient number of acute-care beds and inappropriate utilization of available beds contribute to overcrowding in emergency departments, they are not the only factors.

The ER is part of a complex health-care system in which clinicians are expected to manage a variety of structural restraints that include, beyond bed availability, the expectations and needs of the community, limited resources in the ER, limited community resources and political and managerial expectations.

Drummond says that non-urgent problems require little treatment time and little clinical resources and therefore do not impact adverse outcomes. This is not always the case. Just as the system is complex there is complexity in diagnosis.

The non-urgent patient may require more time and clinical resources if symptoms raise suspicion of a more serious illness. This may involve the ordering of diagnostic tests, waiting for test results, treatment, and waiting for responses to treatment.

Complex problems require complex solutions. There is not just one issue and one problem to be solved as suggested in the article. Patient flow is not a linear process; there are a number of influencing factors.

I am disappointed that Drummond does not have a more concrete suggestion to help the WRHA get it right after stating he has followed their attempts to solve ER crowding for close to 10 years.




If the acute-care health facilities in Ontario are like those in sunny Manitoba, they have no beds because they are taken up by seniors awaiting personal-care-home placement.

I cannot speak for other hospitals, but in my town of Gimli, 11 of the 26 available beds are dedicated to those souls awaiting their placement. When sick folk come to our hospital, rarely is there room for them. They are shipped to other hospitals in our vast health authority.

My solution to this unending problem is to build more care homes. It is not rocket science. Our seniors deserve more respect than having to wait out their time in a facility not set up for their needs. Those folks who encounter illness also deserve to be cared for in their own communities, by their family doctor, not sent to a hospital miles away from home.




Taxing windfalls

Why is it that the deep thinkers in the Manitoba NDP government can't think outside the box? Need more money to finance this lavish-spending, empire-building government?

Instead of increasing existing taxes, where everybody pays, we need a windfall tax. With a windfall tax, all winners of Canadian lotteries in Manitoba pay a 10 per cent withholding tax on everything over $1,000.

Same for casinos and the race track. This would eliminate the need to increase taxes.




Troubled by CFS actions

Re: Seized children wrack traditional community (July 8). I am deeply troubled by the actions of Child and Family Services in this situation.

While the alleged means of physical punishment perpetrated by some parents of the community are unacceptable, in my view, to barge in and forcefully remove the children from their homes and their community will likely leave yet deeper scars on the children.

Why am I reminded of similar tactics employed by some governments of the 20th century?

Neglect or other emotional hurt by parents can be more devastating to children and stunt their emotional growth more, in my view, than physical punishment.

Surely, CFS could have found some wise men and women of Mennonite faith and culture to reason with those community leaders and persuade them to improve their child-rearing methods.




Improving our streets

Re: Beans to you, PST increase (July 8). If you can afford to spend $4 for a coffee, iced latte or a glass of wine, then what's another nickel, even if it is tax?

Every extra nickel of PST will help improve many of our streets and make Winnipeg Mayor Sam Katz smile, because he continually claims he never gets his fair share from the province.



Republished from the Winnipeg Free Press print edition July 12, 2013 A10

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