Seven Oaks, Concordia ER closures won't happen at same time, health officials say

Emergency room changes at Seven Oaks and Concordia hospitals should not happen at the same time, a task force assembled by the Manitoba government says.

Provincially appointed task force urges caution with changes to emergency departments

The province's wait times reduction task force recommends against closing the emergency rooms at Seven Oaks and Concordia hospitals at the same time. (Darren Bernhardt/CBC)

Emergency room changes at Seven Oaks and Concordia hospitals should not happen at the same time, a task force assembled by the Manitoba government says.

The province's wait times reduction task force released its report Wednesday, and said a spring or summer 2018 target date for changes at those hospitals may have been too ambitious.

"These are the biggest changes many of us have seen in our lifetime and there are many structural, operational, behavioural [and] cultural changes that we have to master to get them right," said emergency department wait times reduction committee co-chair Dr. Alecs Chochinov.

"I think we can do it. It's really just a matter of having the proper plan and the proper timing."

The task force was assembled by the provincial government earlier this year to look at wait times for emergency care, as well as surgical and diagnostic procedures, and identify ways to improve the process.

Winnipeg Regional Health Authority officials announced plans to convert the Seven Oaks emergency department into an urgent care centre and close Concordia's ER altogether last April.

Emergency room changes at Seven Oaks and Concordia hospitals should not happen at the same time, a task force assembled by the Manitoba government says. The province's wait times reduction task force released its report Wednesday, and said a spring or summer 2018 target date for changes at those hospitals may have been too ambitious. 2:03

Along with recommendations on how to reduce surgery wait times for priority procedures, the task force recommended a middle-of-the-road approach for changes at Concordia and Seven Oaks — one that still sees changes made but doesn't leave patients in the lurch.

"Not too fast and not too slow," said Dr. John Ross, co-chair of the task force.  "Don't sort of go with our head down and just blast through."

Lori Lamont, acting operating officer for the Winnipeg Regional Health Authority, said they will adopt the recommendation from the wait times reduction task force and "de-couple" the two closures.

She gave no date for when the closures will take place, or which will happen first. 

"There is a risk, if we move too slowly, that we will lose some of that momentum and in fact slide back from the progress that we've made to date. So it is important to find that balance," said Lamont, adding that she believes the health region will require at least 24 months to complete the transition to fewer emergency rooms. 

The health authority is currently deciding which emergency department should close first, she said.

St. B., Grace not ready to absorb patients: report

The report says St. Boniface is not ready to safely absorb a potential 55 per cent increase in patient volume if the emergency rooms at Seven Oaks and Concordia close at the same time.

"The physical space in the existing [emergency department] is old and inadequate even for current volumes of patients," the report's authors said. 

At Grace Hospital, the task force suggests staff could see a doubling in hospital admissions.

The hospital is currently renovating its emergency room (expected to be complete in March 2018) to ensure it has enough physical space to accommodate more hospital visits but, the task force points out, it must also staff enough doctors and nurses to treat an increased number of patients.

At Health Sciences Centre, the task force praised recent improvements to the care provided by the hospital's emergency department and how it's reduced wait times but said the hospital needs investments to see that success continue. 

"It is vital that the HSC be given sufficient human and physical resources to allow them to continue their progress," said the report.

'They've moved hastily': NDP

For the Opposition NDP, the task force's report is evidence the governing Progressive Conservatives have been reckless with changes to emergency health care in Winnipeg.

"They've moved too quickly. They've moved hastily," said health critic Andrew Swan. "They haven't actually had the best interests of Manitoba patients at heart."

No one from the Progressive Conservative caucus was available to speak with reporters Wednesday.

Debbie Boissonneault, president of Canadian Union of Public Employees Local 204, agreed the previous timeline for changes to Winnipeg's emergency rooms could pose harm to patients.

"There are numerous different reports being implemented in part or in full at the same time, and there seems to be no coherent plan on how these changes will impact patient care," she said, referring to numerous reports — including the Peachy report, the KPMG report, and the wait times task force's report — which the government is using to inform changes to Manitoba's health system.

The Victoria General Hospital's emergency room became an urgent care centre in October 2017. (Meaghan Ketcheson/CBC)

Sandi Hrem says her family has always used the Concordia Hospital and she "can't fathom" trying to get to HSC or St. Boniface in an emergency. 

"We need to rally to keep a hospital open in this quadrant of the city."

In September, Hrem told CBC News she believed the actions of some hospital staff and a long emergency room wait at Health Sciences Centre contributed to her 91-year-old mother's death.

She said Wednesday she hopes the province heeds the wait times report, and pauses before Phase 2 of the WRHA overhaul.​

Increase hip, knee, cataract surgeries 

Along with changes to emergency care, the task force also looked at wait times for priority procedures, including MRI scans and surgeries.

The task force's report says hospitals should increase the number of three priority procedures — hip, knee and cataract surgery — to reduce wait times.

For hip and knee surgery, the task force recommends increasing the number of replacements by 900 per year, at a cost of between $2.3 million and $8.9 million. That would mean a 25 per cent increase in surgeries. 

In the 2016-17 fiscal year 3,933 Manitobans had knee or hip replacements, with a median wait time of 29 weeks for the procedures. The Canadian benchmark is 26 weeks, or six months.

Demand for both joint replacement procedures is expected to increase significantly — by five per cent a year — because of Manitoba's aging population, the task force said.

Cataract surgeries should be increased by 2,000 procedures per year, at a cost of between $900,000 and $3 million, the task force said. That's an increase of about 16 per cent in the number of surgeries performed.

The task force also said the province doesn't need to buy or install any more magnetic resonance imaging, or MRI machines, but it recommended existing MRIs be used 16 hours a day and be used more wisely to reduce wait times. In Manitoba, the average wait time is 22 weeks for an MRI scan. 

With files from Aidan Geary and Tessa Vanderhart