Concordia, Seven Oaks emergency rooms to be closed by end of next summer

Concordia and Seven Oaks hospitals will lose their emergency rooms and intensive care units by next summer, the Winnipeg Regional Health Authority announced Thursday.

Officials revealed the June 2019 date for the Concordia emergency department's closure at a press conference about the second phase of the WRHA's dramatic overhaul of the city's health-care services.

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The health authority has no immediate plans for what will take over the vacated areas at Concordia.

"We're looking at other options for the use of that space and the emergency department but our plan doesn't include an urgent care centre," said Lori Lamont, WRHA's acting operating officer.

With acute care services on the way out, Concordia Hospital will offer community hospital care and transitional care services, as well as orthopedic surgery instead.

As part of the continued reorganization, the emergency department at Seven Oaks General Hospital will be converted into an urgent care centre by September 2019.

The changes at Concordia and Seven Oaks were originally supposed to take effect this spring, but were delayed to ensure the renovated ERs at the Health Sciences Centre and St. Boniface Hospital could handle the expected influx of patients.

"The scope of the changes that we are moving forward with in Phase 2 has not changed from our initial plan," said Lamont. "What has changed is some of the timing and sequencing of activities as we've learned more."

Health Minister Kelvin Goertzen said the delay was based on the advice of a wait times task force. 

"We were never been married to a timeline, just married to the evidence," he said.

Despite the change to the timeline, NDP Leader Wab Kinew said the province isn't following the advice from the task force correctly.

"What the advice they received is, is that those changes should be off the table until the renovations are completed," Kinew said. "They didn't stagger the timeline correctly."

The report says that the changes being made to St. Boniface and Grace hospitals are insufficient, Kinew said.

Once renovations are complete, HSC will open a "mid-to-low acuity area of treatment" next January. The expansion of St. Boniface's emergency department, complete with new triage, waiting area and mid-acuity treatment space, is scheduled to be ready by spring 2019. Further improvements, including renovated high-acuity and resuscitation space, will be complete next summer.

A number of services at Concordia and Seven Oaks hospitals will be sent elsewhere.

Mental health services will be consolidated at HSC, St. Boniface and Victoria hospitals this December, with Victoria gaining 52 more beds.

Intensive care units will shift from the two hospitals to HSC next spring and St. Boniface next fall. 

Manitoba Nurses Union president Sandi Mowat is skeptical that renovations to St. Boniface Hospital and HSC will be done in time for the closures. She says ICUs have been at capacity since the closure last year of the ICU at Victoria General Hospital. 

"The original timeline [for the latest ER closures] was supposed to be this spring. We now know that they didn't have enough resources in place to do that," she said.

"So certainly, taking a step back and looking at that is a positive thing. I still think they need to look at it a little bit more, though. We're looking at a very large part of the city that is losing a very valuable resource, and where are those people going to seek medical care? And are they going to the already overcrowded facilities?" Mowat said. 

"I think we're putting the cart before the horse again."

Surgical services at Seven Oaks will transfer to other facilities starting in January. HSC will expand its surgical space as of August 2019.

The changes will "concentrate resources — including staffing and specialized equipment," a news release said.

Mission not accomplished: Goertzen

Goertzen said the first phase of health-care consolidation saw a reduction in median emergency room wait times (15 per cent) and lengths of stay after admission (11 per cent decrease for 50 per cent of patients) since the reorganization began last October.

"Nobody's hung up a 'Mission Accomplished' sign, but [the statistics] are encouraging," he said.

Mowat says wait times, measured by median time to see a physician, don't tell the whole story. 

"What about how long it takes you to be treated?" she said. "Are you being discharged? Are you being admitted?… Do you need a test somewhere? What are those times?" 

Mowat says every day, nurses tell her about overcrowding with unprecedented numbers of patients being seen in emergency rooms. The reorganization at St. Boniface caused nurse positions to be moved around, especially in the labour and delivery area, which she says is adding to the strain. 

"[Nurses'] concern is they're being stretched thin, they're working hours, they're tired, they're worried about providing safe patient care" she said. 

Phase 2 already underway

The second phase of the overhaul began earlier this spring, with plans to demolish a recently emptied ward at St. Boniface Hospital and the re-opening of Grace Hospital's ER, more than five times the size of its replacement.

The province's new prescription for health-care delivery began last year, when it was announced half of the city's emergency departments would close to consolidate emergency care at HSC, St. Boniface and Grace. The revamp is meant to create operating efficiencies and cut wait times.

The plan included converting emergency departments at Victoria and Seven Oaks to 24/7 urgent care centres, while ending 24-hour emergency care at Concordia.

The Misericordia Health Centre's urgent care centre was also closed and became a community intravenous therapy clinic.

Moving the community IV service from Lions Place to Misericordia Health Centre — a holdover from the first phase of the reorganization — will be complete this September.

Nursing jobs available

As of this month, 269 people were laid off in the city's health-care system as a result of the consolidation. Sixty-one secured other work, while 94 people did not find another position, the WRHA said.

Of the total laid off, 86 people were nurses and 63 have since found work. The health authority has posted 112 nursing vacancies, Lamont said.

"There are jobs in our system for those who continue to want to work in the Winnipeg health region."

Goertzen said changes to rural emergency care will be announced in mid-summer.

"I hope that the results from the Winnipeg changes will give some confidence for those in rural Manitoba that change, while it can be difficult, can work."