Is it an emergency? The difference between an ER and urgent care

Former KPMG consultant will oversee Health Sciences Centre's transition to new health organization

The largest health-care revamp in a generation has many Winnipeggers wondering what will happen after half of Winnipeg's emergency departments shut down and two urgent care facilities open.

On Friday, the Winnipeg Regional Health Authority announced the plan which will see Health Sciences Centre, St. Boniface Hospital and Grace Hospital as the primary hospitals offering emergency services in the city. 

The emergency departments at Victoria and Seven Oaks will be converted to 24/7 urgent care centres while the Misericordia Health Centre's 24-hour urgent care centre will be closed and converted to a community intravenous therapy clinic.

The idea of shuttering an ER can sound concerning but WRHA says it will mean streamlined services and shorter wait times. 

Why would they get rid of ERs? 

The vast majority of people who show up to Winnipeg's ERs don't even need "urgent" care, never mind emergency care, according to a 2017 report by the Manitoba Centre for Health Policy called Factors Affecting Emergency Department Waiting Room Times in Winnipeg. 

- REPORT Factors Affecting Emergency Department Waiting Room Times in Winnipeg 

Hospitals use a scale of 1 (highly urgent) to 5 (non-urgency), and only 15 per cent of patients are triaged at 1 or 2. Around 40 per cent are rated "urgent" (3) and another 40 per cent as "less urgent," 4 or 5. 

Fed up with long wait times, more and more patients are leaving the ER before even seeing a doctor; the number reached 10 per cent in 2012-13, up from six per cent in 2004-05. 

When should I go to an ER?

So how do you know if your health issue is an emergency-room emergency? 

According to the WRHA, the ER is your best bet when you've got a life-threatening or potentially life-threatening condition, like severe chest pains, stroke or trauma.

The WRHA also provides a handy list of conditions that should definitely send you to the ER:

- Heart attack

- Stroke

- Major trauma

- Severe head injury

- Loss of limb in an accident

- Severe difficulty breathing (due to an allergic reaction or another cause)

- Sexual assault

- Domestic violence

- Severe bleeding

- Any time a person is unconscious

Emergency departments are open 24/7 on a walk-in basis, so you can go anytime.

A reminder: if you've got something going on that seems ER-worthy, you can also call 911.

When should I go to an urgent care centre?

This is the place for all those concerns that aren't life-threatening but do need to be taken care of right away. 

Fracture a bone? Need stitches? Severe flu symptoms? If your regular doctor's not available, get yourself to an urgent care centre.

Winnipeg's existing facility — the Misericordia Urgent Care Centre — is also open 24 hours a day for the time being. 

Here are some reasons you might go to an urgent care centre:​

- Fever or flu symptoms

- Fractures or sprains

- Minor burns

- Headaches, earaches

- Nosebleeds

- Rashes

- Sore throat

- Urinary problems

- Vomiting

Still not sure where to go? Call the 24-hour Health Links helpline at 204-788-8200, or toll-free at 1-888-315-9257.

What else does an urgent care centre offer? 

At the Misericordia centre, staff can set and cast broken bones, clean and stitch cuts and provide counselling, just to name a few of the services available.

You can also get crutches there for $25.

Specialists available include a physiotherapist, occupational therapist, dietitian, respiratory therapist, social worker and more.

Will this make my wait for care shorter?

WRHA services are spread too thinly across the emergency departments, according to the health region's website explaining all of the changes.  

"Having three emergency departments will allow us to concentrate our specialists and diagnostic services in fewer facilities, resulting in better access and shorter wait times," the website said. 

The Manitoba Liberal Party, meanwhile, said modelling and test runs should to be done to figure out how people will use the new emergency rooms and urgent care centres. 

On Friday, Matt Wiebe, the NDP's health critic, said "when you close an emergency room in a community, that affects the care they receive."

Wiebe said he believes there is room to find efficiencies in the system, but closing ERs is not the answer. The report that first recommended the repurposing of emergency departments was commissioned by the NDP.