November 14, 2019

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Phase 2 of WRHA's overhaul includes Concordia ER closure

Hey there, time traveller!
This article was published 31/5/2018 (531 days ago), so information in it may no longer be current.

Hey there, time traveller!
This article was published 31/5/2018 (531 days ago), so information in it may no longer be current.

The closure of Concordia Hospital’s emergency department and conversion of the Seven Oaks General Hospital’s ER into an urgent care centre next year will be part of Phase 2 of the Winnipeg Regional Health Authority’s health care overhaul, it was announced Thursday.

"We’re very pleased with how Phase 1 has gone, we’re excited about Phase 2, and we’re excited about the end result that this is going to have for Manitoba patients," said Kelvin Goertzen, minister responsible for health, active living and seniors.

Phase 2 timeline

• May 29, 2018 — New, expanded Grace Hospital emergency department opens.

• August 2018 — Health Sciences Centre surgical ICU to expand.

• September 2018 — Community IV service moves to Misericordia Health Centre from Lions Place.

 TBD 2018 — Concordia Hospital and Seven Oaks General Hospital will start to focus on transitional care services rather than serious community hospital care.

 December 2018 — Mental health services at Grace Hospital and Seven Oaks will move to HSC, St. Boniface Hospital and Victoria General Hospital.

May 29, 2018 — New, expanded Grace Hospital emergency department opens.

August 2018 — Health Sciences Centre surgical ICU to expand.

September 2018 — Community IV service moves to Misericordia Health Centre from Lions Place.

TBD 2018 — Concordia Hospital and Seven Oaks General Hospital will start to focus on transitional care services rather than serious community hospital care.

December 2018 — Mental health services at Grace Hospital and Seven Oaks will move to HSC, St. Boniface Hospital and Victoria General Hospital.

January 2019 — Surgical slates will shift to Seven Oaks from other hospitals.

January 2019 — HSC emergency department will expand to offer a mid-to-low acuity treatment area.

Spring 2019 — St. Boniface's new triage, waiting area and mid-acuity treatment space in its ER will open.

June 2019 — Concordia's ER will close.

Summer 2019 — St. Boniface ER renovations complete and will include a renovated high-acuity and resuscitation space.

September 2019 — Seven Oaks ER will convert to an urgent care centre.

September 2019 — HSC intermediate ICU expansion will occur.

TBD 2019 — HSC will formally transition out of the WRHA’s control, as it becomes a provincial hospital.

-- source: Winnipeg Regional Health Authority

He later told reporters shaking up the health-care system is inevitable if there's to be improvements in Manitoba. 

"I hear the disruption and I take no pleasure in that, none at all. But I also know, you can’t change a system where there’s some 55,000 people without disruption. It’s just not possible," Goertzen said. 

"We’re not making the decisions on an emotional basis. We’re looking at the evidence and the evidence is telling us that people are going to be better served."

Concordia ER closure 

First up in significant changes is the closure of Concordia Hospital's emergency department in June 2019. 

Lori Lamont, acting chief operating officer of the WRHA, wouldn't yet say what replacement options the authority is considering to fill the cavity.

Neither would Goertzen, though he did tell reporters the space won't be converted into an urgent care centre.

"We aren’t in a position to tell you what (the ideas) all are now, but I think there’s a recognition that there are some within the system, particularly in Concordia, in that area... who are maybe using the Concordia Hospital now – the ER – in a way that’s not particularly appropriate, that they’re not high acuity. There needs to be something for individuals like that to go to," he said. 

MIKE DEAL / WINNIPEG FREE PRESS</p><p>Lori Lamont, Acting Chief Operating Officer and Vice-President, Nursing and Health Professionals for the Winnipeg Regional Health Authority</p>

MIKE DEAL / WINNIPEG FREE PRESS

Lori Lamont, Acting Chief Operating Officer and Vice-President, Nursing and Health Professionals for the Winnipeg Regional Health Authority

In a prepared statement, Manitoba Liberal health critic Jon Gerrard pushed for urgent care.

"If the PCs are determined to close Concordia’s ER, they should at least open an urgent care centre for the community," he said. 

"Manitobans have known for months now that emergency rooms at both hospitals (Concordia and Seven Oaks) will be closed. What we don’t know is what their specialized and focused areas of care will be."

Seven Oaks ER switches to urgent care 

The next major shake-up will be transitioning Seven Oaks General Hospital's emergency department to an urgent care centre. That's scheduled to happen in September 2019. 

Emergency departments at St. Boniface Hospital and Health Sciences Centre will be expanded to accommodate patients diverted from Seven Oaks and Concordia. Mental health services will also be redirected from Seven Oaks and Grace Hospital to HSC, St. Boniface and Victoria General Hospital. 

Manitoba NDP Leader Wab Kinew lamented the conversion of Seven Oaks to urgent care and the closure of Concordia. He wants both facilities to keep their ERs. 

"My concern is that peoples’ care is going to suffer. Because if they close Concordia, if they close Seven Oaks, it’s tens of thousands of patients who are going to have to go to the remaining emergency departments in the city. And what we’ve heard from the experts, from the government’s own advisors so far, is that in their current states, the emergency departments are not equipped to handle that influx of patients," Kinew said.

HSC and St. Boniface will both be renovated, as the Grace already has been, to make room for more patients before Concordia's closure and Seven Oaks' transition.

Phase 1 changes saw wait times improve: WRHA

Hospital wait times have decreased by about 15 per cent on average since the first round of health-care changes, according to the WRHA. The average length of stay for inpatients also improved by 6.6 per cent, said interim chief executive officer Réal Cloutier.

Unions representing health-care workers cautioned against optimism about those statistics, however.

MIKE DEAL / WINNIPEG FREE PRESS</p><p>Kelvin Goertzen, Minister of Health, Seniors and Active Living</p>

MIKE DEAL / WINNIPEG FREE PRESS

Kelvin Goertzen, Minister of Health, Seniors and Active Living

Sandi Mowat, president of the Manitoba Nurses Union, said while wait times may have improved, she's hearing from members patient care could be put in jeopardy as staff is being overworked.

"They’re reporting that everything is wonderful and everything is going to plan. I’m not hearing that from the actual people who are working in these units and taking care of these patients. What I’m hearing is the concern for the fact that they’re working long and hard hours, stretched very, very thin and doing the best they can," Mowat said.

She pointed to St. Boniface Hospital as a prime example where nurses have already worked more overtime this year than they did in all of 2017.

"And still we have more changes coming, in a time where I don’t believe the evaluation has proven that we should be looking at that," Mowat said.

Advisors told officials to slow down health-care transitions

After the wait times reduction task force released its final report in December, showing St. Boniface needed increased patient capacity, the province and the WRHA decided to slow down some of the planned changes for Phase 2.

Converting Victoria's emergency department into an urgent care centre in October, also had a learning curve, Lamont said.

"We’ve used that experience a lot, because certainly when we planned the changes at the Vic, we used some statistics, visit volumes, and looked at where people lived, what kind of emergency algorithms we need to put in place for our EMS providers, all kinds of things," she said.

Lamont said no critical incidents stemmed from changes at Victoria, according to WRHA's analysis. 

Goertzen said the Tory government has "never been married to a timeline, just married to the evidence," on health-care changes.

Unions have criticized the planned changes nearly every step of the way, and did so again Thursday. 

MIKE DEAL / WINNIPEG FREE PRESS</p><p>Réal Cloutier, Interim President and CEO of the Winnipeg Regional Health Authority</p>

MIKE DEAL / WINNIPEG FREE PRESS

Réal Cloutier, Interim President and CEO of the Winnipeg Regional Health Authority

Michelle Gawronsky, president of the Manitoba Government and General Employees' Union, said patients and health-care workers "are still caught up in the chaos from the first round of health-care cuts, and instead of reversing those cuts, this government is surging ahead with new ones."

"The rosy report the government painted today on wait times and hospital stays is far different than what I’m hearing from front-line workers," she said. 

CUPE Local 204 president Debbie Boissonneault echoed frustration. The union represents about 26,000 workers in Manitoba health facilities.

"Instead of listening to the concerns of front-line workers and the community, the government continues to dig in its heels with their plans to close the Concordia and Seven Oaks emergency rooms," Boissonneault said in a prepared statement. "Health-care workers deserve respect and they deserve to be heard, and that is not happening." 

Goertzen said critics are welcome to nit-pick the plan. 

"This is a democracy. If I put 20 health-care workers in a room, I’ll probably get 15 different opinions," he said. "But I hope there’s an assurance that we’re following evidence and adjusting as we go along as a result of that evidence."

KPMG report released in full

The province also released the full 700-some pages of KPMG's health-care sustainability and system review Thursday afternoon. Portions of the report were previously published and acted upon by the government, such as the health-care consolidation.

A few portions of the report are still blacked out because they contained personal information about government employees, said a spokesperson from the health department.

One suggestion from KPMG is for Manitoba to mirror Ontario's use of nurse hours per patient, which are fewer and would save an estimated $90 million.

Kinew took issue with that recommendation saying, "that's an exercise in cutting costs, it’s not an exercise in improving health care."

jessica.botelho@freepress.mb.ca

jane.gerster@freepress.mb.ca

Jessica Botelho-Urbanski

Jessica Botelho-Urbanski
Legislature reporter

Jessica Botelho-Urbanski covers the Manitoba Legislature for the Winnipeg Free Press.

Read full biography

History

Updated on Friday, June 1, 2018 at 12:18 PM CDT: Caption fixed.

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