People looking for treatment in Winnipeg on Tuesday will face the first emergency room closure in what Manitoba's health minister has called the "most significant change in the health-care system in a generation."
As of 8 a.m., Victoria Hospital's emergency room will officially be closed and it will be an urgent care centre. On the same day, the hospital's Mature Women's Health Centre will close and patients will be shifted to Health Sciences Centre, and a new wait-times website will launch.
Misericordia's urgent care will be closed Monday night at 8 p.m. and will become a community intravenous therapy clinic.
Under the changes, Health Sciences Centre, St. Boniface Hospital and Grace Hospital will become the only hospitals with ERs in Winnipeg.
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The Winnipeg Regional Health Authority has a plan in place to help smooth the transition for patients needing care and not sure where to go, said Lori Lamont, vice-president of interprofessional practice and chief nursing officer of the heatlh authority.
"We expect that there will be some people who will use the local hospital and we will need to make sure that they get to where they need to be, and we have those contingency plans in place," she said.
Victoria ER becomes urgent care centre
If someone does show up at the Victoria Hospital expecting an emergency room, depending on their illness, they might not notice any difference at all, Lamont said.
About 60 to 70 per cent of people who used the Victoria came to the emergency room with an urgent-care illness or injury, Lamont said.
Those who arrive at Victoria with a more serious illness can still be seen by staff at the newly converted urgent care centre.
Emergency physicians and nurses will be at the hospital, Lamont said. If they are needed, they will help stabilize the patient and arrange for transportation to the appropriate place, she said.
"If you have a serious emergency such as a stroke or a heart attack, we really encourage people to call 911," Lamont said.
"Not only will that get you to the right place, but it's also really important that our EMS providers have protocols that actually start the life-saving treatment immediately in their home."
Misericordia will be intravenous therapy clinic
There will also be a physician and a nurse on duty at Misericordia, but Lamont said people should be going elsewhere unless it's an issue with eyes — the Eye Care Centre of Excellence will continue to be open all hours of the day.
The health region also worked with staff at Misericordia to identify 20 vulnerable people from the surrounding community that staff worried would be negatively affected by the changes. They worked with those people and their care teams to connect them with family doctors, Lamont said.
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If people still show up at Misericordia, there will be a discussion with them about whether they will be able to make it to an emergency room or urgent care centre on their own, or if an alternative arrangement needs to be made, Lamont said.
"We anticipate there will be some people arriving in the next 24 hours, 48 hours, but after that, we anticipate Winnipeggers will go to where the service is available," she said.
The health region is also moving some in-patient services to support the changes.
The rehabilitation and geriatric units from Health Sciences Centre will move to Victoria Hospital, and the health region is working with the people in the units and their families to make the move the least disruptive possible, Lamont said.
Health Sciences Centre and St. Boniface have also prepared for an increase in patients.
They have new processes to triage and move patients, which have been tested with success, and there are more staff at all three emergency departments, including Grace Hospital, Lamont said.
"The big difference that they will notice is that they will move more quickly from triage back into a treatment space," she said. "So it's really about using the spaces in the departments differently."
Many of the other changes won't happen until spring 2018, and for people going to Seven Oaks and Concordia hospitals, it is "business as usual," Lamont said
Seven Oaks' emergency department will be converted to an urgent care centre like the one at the Victoria and Concordia Hospital's emergency room will close.
Crews from a sign company took down the Misericordia's urgent care sign on Sunday night, and the emergency signs at Victoria will be taken down on Tuesday morning.
The health region also urges anyone who might be confused about where to go to contact Health Links any time at 204-788-8200 or 1-888-315-9257.
"We recognize that people in Winnipeg have, by and large, done a very good job of selecting when urgent care was appropriate with Misericordia," Lamont said.
"We expect that people will continue to make appropriate choices but recognize that's not always possible, and so we have put some safeguards in place at all of our facilities."