Half of Winnipeg's ERs closing in biggest health-care revamp 'in a generation'

Half of Winnipeg's emergency departments are shutting down as part of a sweeping move by the Winnipeg Regional Health Authority to slay wait times and find efficiencies in the city's health system.

A plan announced Friday by the Winnipeg Regional Health Authority will see three emergency departments close, leaving 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 Concordia's department will be closed and no longer provide 24-hour emergency services.

The Misericordia Health Centre's 24-hour urgent care centre will be closed and converted to a community intravenous therapy clinic.

The objective is to streamline and concentrate resources, rather than have them spread over multiple sites, explained WRHA president and CEO Milton Sussman at Friday's news conference at St. Boniface Hospital.

"Right now, many patients wait too long for care, stay too long in hospital or need to visit multiple sites to get the care they need," he said. "With this announcement, we begin the process of healing our health system, taking important steps that focus squarely on our patients.

"Both significant and sensible, these changes address systemic challenges that have hindered quality care and taxed our resources."

What will change?

The urgent care facilities at Seven Oaks and Victoria General will now handle patients with non-life-threatening illnesses and injuries, while traumas and other acute care patients will be treated at the three remaining emergency departments.

Health officials at Friday's news conference said 85 per cent of people who visit emergency rooms in Winnipeg go in with "fairly low-level types of injuries."

The remaining ER departments will continue to look at all types of emergencies, but there is hope that people will self-determine whether they should instead go to an urgent care centre, said WRHA senior vice-president Dr. Brock Wright.

"The existing emergency departments will still look after the full spectrum of health-care problems, from the most urgent to lesser emergencies," he said.

Health officials said Grace Hospital was chosen as the one community hospital to maintain its current emergency services because it was the best equipped to deal with the increased capacity.

Shovels are already in the ground for a new ER at Grace Hospital that is scheduled to open next spring, said Lori Lamont, the WRHA's vice-president of interprofessional practice and chief nursing officer.

"Of the the community hospitals, [Grace] has the best ability to take on that increased surgical, medical activity," she said.

As part of its transition, Victoria Hospital will add 50 beds for mental health services, while Seven Oaks will focus on renal service and rehab for the elderly, and will be the go-to centre for endoscopy.

Concordia will take on more orthopedic surgeries and continue to do hip and knee replacements.

The conversion of Seven Oaks and Victoria to urgent care centres is expected to begin this fall. The other initiatives will occur over the next years, according the WRHA.

Cost savings and job losses unknown

It is unclear how much this will cost or save the WRHA. Sussman refused to give a dollar amount when asked by reporters.

"Efficiencies with this plan will actually reduce some of our costs," he said.

Officials with the WRHA were unable to guarantee there would not be job losses.

"This will be large and it will be disruptive to our staff," said Lamont. "We don't expect any significant job loss."

She said all medical staff, including nurses, will be affected by the change and jobs will be shifted.

An internal memo sent to WRHA staff on Friday stated some staff movement will occur as early as this summer, while other moves will take as long as two years to implement.

Sussman's memo says WRHA officials "are confident that we will ultimately be able to provide a job for any direct care staff member who wants to remain in the health system within Winnipeg."

'Doing nothing was not an option': Goertzen

Health Minister Kelvin Goertzen said the changes are being made to create efficiencies in a system that had patients waiting too long for treatments.

"Doing nothing was not an option. Things were not going to improve if we didn't change things," he said, adding the province couldn't continue to pour money into a system that wasn't working.

"I recognize that this will likely be the most significant change in the health-care system in a generation. Big change isn't easy.

"It won't be easy for those in the health-care system, we understand that, but we need to make things better."

All of the changes can be found on a WRHA website called Healing Our Health System.

The overhaul of the system comes on the heels of a 233-page report by health consultant Dr. David Peachey.

The Nova Scotia-based physician held hundreds of hours of consultations with community representatives, regional health authorities and staff, unions and associations, Indigenous organizations, clinical leaders in major specialties across the province and other important stakeholders, WRHA officials said.

- READ THE REPORT: Clinical and Preventive Services Planning for Manitoba

The aim of the report was to address issues ailing the system. Statistics show that the Winnipeg region lags behind the national average in many health-care categories, including wait times in emergency departments and in-patient length of stay.

"Cities such as Vancouver, Calgary and Ottawa have fewer emergency departments per capita yet have shorter wait times than Winnipeg. Clearly, more is not better. Three emergency departments will allow the WRHA to provide more focused and specialized care," said Peachey.

Key changes

- Emergency and acute health services consolidated at Health Sciences Centre, St. Boniface Hospital and Grace Hospital.

- Two urgent care centres, for cases that are serious but not life-threatening, at Seven Oaks Hospital on the north side of the city and Victoria Hospital in the south.

- Specialized areas of focus for Winnipeg's community hospitals and health centres aimed at providing "the right care in the right place at the right time."

- Concordia Community Hospital will continue to offer specialty care in orthopedics and will also offer geriatric rehabilitation services and transitional care for patients waiting to get into personal care homes.

- Seven Oaks Community Hospital will continue to offer specialty care in out-patient renal services and will also offer an emphasis on elective endoscopy procedures as well as rehabilitation and transitional care for older patients.

- Victoria Community Hospital will continue to offer specialty care in day surgery and expanded in-patient mental health services. In addition, the hospital will focus on offering mental health services to older patients in geriatric mental health.

- Deer Lodge Centre will continue to offer specialty care in geriatric rehabilitation, chronic care and long-term personal care. Deer Lodge will also focus on special needs residents, including care for those with dementia.

- Misericordia Health Centre will continue to specialize in eye surgery and treatment, long-term and interim care for the elderly and respite care. The urgent care centre will be repurposed to accommodate an expanded community intravenous therapy clinic.

- Riverview Health Centre will continue to specialize in dementia care, respite services and respiratory chronic care and will continue its work in Alzheimer's care.

On mobile? Read the memo to WRHA staff here