The McGill University Health Centre (MUHC) is considering making major changes to the way Montreal's Lachine Hospital delivers care to patients.
Citing staffing problems and a decrease in the activity volume at the hospital, the MUHC is evaluating two different proposals.
One would see the hospital — which earlier this month decided to stop admitting patients who arrive by ambulance and only perform day surgeries — return to operating as a fully functional community hospital.
In the second scenario, the hospital would shift its focus to developing clinics that follow up on patients with chronic diseases and hospitalized patients who are clinically stable.
"We can confirm that two scenarios are being developed by the teams and that in both scenarios, 60 hospitalization beds will be used," the MUHC, which oversees the hospital's operations, said in a statement.
"Patients will therefore be hospitalized in both scenarios, but will have different profiles, with different clinical needs, depending on the services that can be offered."
According to the MUHC, consultations between medical and administrative personnel are ongoing and hospital management met with community representatives on two separate occasions to discuss the changes.
It says it hopes to come to a decision by the end of April.
Lachine Mayor Maja Vodanovic says that she is waiting to get all the facts before weighing in on what she thinks is the way forward. She says she is confident that patients will benefit from changes that are made to the care provided.
The hospital is already undergoing a $223 million expansion to its facilities.
"We're building new operating rooms in new palliative care and new rooms for patients," said Vodanovic.
"Overall, this is good. We just have to figure how we're going to work with MUHC to have the hospital that serves the needs of Lachine and that is also useful for … the larger MUHC hospital."
Dr. Paul Saba, who practices family medicine at the hospital, worries the hospital will no longer serve the community.
Saba says there is enough medical personnel to keep the hospital a fully functioning community hospital, and that scaling back services would hurt people in need of care — whether in Lachine, the West Island or other parts of Montreal.
"This is not a good situation for anybody, [not] for the patients in the West Island, and it's also definitely not a benefit for people downtown because they're already overrun," he said.
He also says the proposed changes did not go over well with his colleagues when they were presented at a meeting last week.
"They believe in — and are fully committed to — keeping the hospital as a fully functioning community hospital with emergency room 24/7, ambulance services 24/7 and a fully functioning ICU."
Saba proposes a third option that would see the hospital return to a fully functioning community hospital with ambulance services and around the clock emergency rooms and ICUs but with the addition of expanded ambulatory care.
Quebec's Ministry of Health says the MUHC's proposals would benefit patients on the hospital's territory.
"This type of reorganization has already been done elsewhere, such as at Jeffrey Hale Hospital in Quebec City, and there have been positive results in terms of providing quality services," the Ministry replied in a statement, referring to a hospital which transformed its emergency room into a clinic for minor emergencies last year.
"This is an effective way to meet the needs of patients who require less urgent care and who will walk to the hospital, taking pressure off other hospitals in the area."