Hospital boss kept in dark about changes

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This article was published 29/08/2017 (2972 days ago), so information in it may no longer be current.

When the Winnipeg Regional Health Authority announced last spring it was closing three emergency rooms along with Misericordia’s urgent care centre, it caught many by surprise — including Misericordia’s top boss.

“We didn’t have any prior warning,” Rosie Jacuzzi, president of Misericordia Health Centre, told the Free Press Monday.

A series of staff memos obtained by the NDP shed light on how little advance warning employees were given — and highlight Jacuzzi’s consternation over the closure — as the WRHA moved ahead with overhauling health-care delivery in the city.

On April 7, the WRHA announced emergency services will be consolidated at three hospitals — Health Sciences Centre, St. Boniface Hospital and Grace Hospital — and the ERs at Victoria and Seven Oaks hospitals will be converted into urgent care centres, while Concordia’s department will close.

The changes were based on recommendations from Nova Scotia consultant David Peachey, who issued a 233-page report to the government in February, but made no mention of closing Misericordia’s urgent care.

“We thought we’d be helping other ERs transition to urgent care centres, not closing ours,” Jacuzzi wrote in a memo to Misericordia staff just three days after the overhaul was announced.

She made clear in the memo her immediate concerns: why now, given millions was spent to move diagnostic imaging and a lab closer to urgent care? What will be the impact on programs that work as direct support to urgent care? Where will the eye emergencies go? Her list ended in a revealing quip.

“Ad infinitum,” she wrote for her final question, Latin for “without end or limit.”

NDP health critic Matt Wiebe said the memos illustrate far more than just senior staffers’ surprise over the announced changes. The Concordia MLA said it is another example of how the changes are being driven by a provincial mandate that the WRHA find $83 million in annual savings.

“It’s very clear that (senior staff) believe the guiding principle of this is to cut the $83 million in health funding on the direction of the Pallister government,” Wiebe said. “Closing this will certainly help them meet that goal, but it will certainly not help meet a better patient care goal.”

Jacuzzi said she couldn’t speak to that since she wasn’t part of the decision, although she wrote in a May memo that it was unrelated to the performance of Misericordia’s urgent care.

It was, she wrote, based on “how to provide better care for the people in Manitoba within funding provided by the Government of Manitoba and the direction to save $83 million.”

The WRHA’s interim president and CEO stressed it’s not about finances.

“What we’re targeting for is quality and improvement in the way patients go through our system,” Réal Cloutier said. “We had every hospital and every emergency department trying to do everything for everybody and we couldn’t sustain it.”

Financing, however, is a crucial factor with respect to long-term sustainability.

Cloutier said the WRHA didn’t consult with Misericordia, nor did it consult with the community hospital it chose to be the third acute care centre (Grace Hospital) because “the reality is nobody would want anything to change.” Instead, the WRHA’s regional clinical experts made the decisions and hospitals were informed the same day as the public.

With respect to the millions Misericordia has spent on shifting diagnostic imaging to be closer to urgent care, Cloutier said the WRHA will look at “alternate uses.”

“It’s not necessarily all dependent on urgent care being there,” he said.

Conversations with Misericordia staff are ongoing, Cloutier said, but did note discussions about how the facility will be staffed in case people present with urgent care cases after Oct. 3 have ended. One doctor and one nurse will remain available to help address and redirect any urgent medical issues, as well as to handle any patients who present with specific eye care needs.

Already, he said, urgent care visits at the centre have declined 12 per cent this year from 38,614 during the 2015 and 2016 fiscal year.

As for whether the other hospitals and extended hours at access centres will be able to absorb Misericordia’s patients, specifically those marginalized persons living in the area adjacent to the hospital, Jacuzzi can’t say.

“I’ve never really read anywhere it’s good to close urgent care,” she said. “I guess time will tell.”

And just five weeks before the urgent care centre is scheduled to close, Jacuzzi said she still doesn’t have an adequate reason for why it has to be shuttered.

“(At least) none that I’ve been satisfied with.”

jane.gerster@freepress.mb.ca