A shortage of critical care nurses at St. Boniface Hospital is being cited as the main reason for the backlog of elective cardiac surgeries. (John Woods / The Canadian Press files)
Elective cardiac surgeries are being cancelled at St. Boniface Hospital as the wait list for operations toppled over the 100-person mark this week, the Free Press has learned.
Hey there, time traveller! This article was published 1/3/2019 (778 days ago), so information in it may no longer be current.
Elective cardiac surgeries are being cancelled at St. Boniface Hospital as the wait list for operations toppled over the 100-person mark this week, the Free Press has learned.
Réal Cloutier, president and chief executive officer of the Winnipeg Regional Health Authority, confirmed Friday there were 102 people waiting for elective cardiac surgeries, which is up at least 70 per cent from October.
The WRHA couldn’t provide the average number of people usually on its elective cardiac surgery wait list Friday, though the Manitoba Nurses Union said it believed 40 to 50 people was close to the norm.
The median wait times for cardiac procedures currently vary from six days for emergent and urgent surgeries, to 19 days for semi-urgent operations and 68 days for elective procedures.
St. Boniface is the only Winnipeg hospital where the cardiac surgeries occur, Cloutier said. He blamed a shortage of critical care nurses as the main reason for the backlog, although he couldn’t say exactly how many surgery cancellations have occurred recently.
"The beds are there. It’s having the nursing staff to look after the patients," Cloutier said, noting cardiac patients require longer after-care from nurses post-surgery.
"So part of the issue in the health-care system (is) there’s always a bit of ebb and flow in terms of vacancies in critical care. I’ve seen it over the years," he said. "It’s really about making sure that we’re getting nurses interested in... the critical care education program, and making sure we’re anticipating vacancies in the area."
The nurse vacancy rate in the WRHA’s two cardiac critical care units (St. Boniface and Health Sciences Centre) is currently 22 per cent, which works out to 17 empty positions among the baseline cohort of 79 nurses.
The most recent class of the Winnipeg Critical Care Nursing Education Program graduated 33 nurses last week. According to the WRHA, all 33 accepted positions in the field, 12 of them at the St. Boniface cardiac program. Class sizes vary for the six-month course, which is offered twice a year to nurses who have at least one year of acute nursing experience.
Cloutier acknowledged there is difficulty trying to fill the nurse vacancies in critical care, since "you just don’t necessarily recruit a nurse in this area overnight."
In an emailed statement, Manitoba Health Minister Cameron Friesen noted the new critical care grads will join six nurses hired in the same area this year.
While the elective cardiac surgery wait list numbers are "higher than we’d like to see," Friesen said, he pointed out the average number of people waiting has been lower over the past 12 months than it was during the NDP’s final year in government. (The Tories were elected in 2016.)
WRHA president and chief executive officer Réal Cloutier said 102 people are waiting for elective cardiac surgeries, up 70 per cent from October. (Mike Deal / Winnipeg Free Press)
He also attempted to highlight the virtues of reorganizing the health-care system to quell staff shortages.
"While the current vacancy rate within the WRHA’s two critical care units are within normal ranges, the situation validates the need to reorganize and simplify what experts have called an overly complex health system," he said.
"Consolidating services and developing a provincewide clinical and preventive services plan will allow the system to better manage normal fluctuations in demand and capacity, improving the care patients receive."
Cloutier said the WRHA’s clinical executive team is working with staff at St. Boniface to identify "the root causes" of the cardiac program’s problems, beyond a nursing shortage.
MNU president Darlene Jackson said members have been pointing to a lack of ICU beds in the health-care system as a contributing factor causing elective surgery cancellations, something Cloutier disagreed with.
'The beds are there. It’s having the nursing staff to look after the patients.'
‐ Réal Cloutier
"That’s certainly not what we’re hearing from nurses. That’s who I get my information from," Jackson countered.
She also pointed to issues with acuity, where cardiac patients are staying sick and requiring longer stays in ICUs, as a problem.
The union leader said nurses are working increasing amounts of overtime — both elective and mandated by their bosses — to cope with increased patient volumes and a "chronic shortage" of staff.
The WRHA is planning to close the emergency departments at Concordia Hospital in June, and at Seven Oaks General Hospital in September, converting the latter facility into an urgent care centre.
Manitoba NDP Leader Wab Kinew has echoed a common sentiment about wanting to see the emergency rooms stay open. He said the cardiac program’s surgery backlog is a symptom of a system-wide problem.
"This is not happening by accident. This is a direct result of (Premier Brian) Pallister’s rushed changes to the health-care system," Kinew said.
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Winnipeg Regional Health Authority president and chief executive officer Réal Cloutier said emergency room wait times were higher in February than in January, a month that already exceeded December waits.
On Thursday, the WRHA posted its aggregate monthly wait time numbers for January, which showed a bump year over year in median wait times — from 1.67 hours last year to 1.87 hours in 2019.
Cloutier said Friday the region believes there are a few causes behind the bump, including seasonal increases in influenza and respiratory illnesses, which creep up every winter.
Patients are also taking longer to be discharged from hospital, he said, because of lingering sickness.
Cloutier acknowledged consolidation connected to the Manitoba government’s health system changes will affect wait times as hospitals adjust resources and staff in the short term.
In the long term, “it is certainly our view that once we finish the (hospital) consolidation in the fall of 2019, that will give us the additional capacity and throughput to be able to manage patients in a better way. That was why we made the change and that was why we’re going to finish the change,” Cloutier said.
“Wait to see the year-end number,” he said about the overall wait times, which the WRHA hopes will match the Canadian average of 1.2 hours by April 2021.
Cloutier also provided an update about the WRHA’s recent need to use contingency beds. On Feb. 20, he reported there were 72 over-capacity beds being used within Winnipeg hospitals due to an influx of patients.
On Friday, Cloutier said the number of beds actually veered up toward the mid-80s at one point last month, but as of this week, the WRHA is using 63 extra beds.
— Jessica Botelho-Urbanski
Family medical centre to close
THE Family Medical Centre at St. Boniface Hospital will close July 1.
The Winnipeg Regional Health Authority announced Friday the centre’s pending closure after nearly four decades of operation.
The move will affect more than 3,200 patients, who will be directed to other primary health-care providers in Winnipeg, said Gina Trinidad, the WRHA’s chief health operations officer.
She said all patients from the family medicine centre will be contacted and set up with a new provider. Those with questions can call a dedicated hotline (204-258-1010) starting Monday.
There were about 20 medical residents who trained at FMC at a time, though Trinidad noted within recent years, education programs expanded across the health-care system. Students will continue training at access clinics city-wide.
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