Manitoba

Concordia Hospital ER is no more: The difference between an ER and urgent care

The largest health-care revamp in a generation has many Winnipeggers wondering what will happen after half of Winnipeg's emergency departments shut down and two urgent care facilities open.

Shuttering ERs can sound concerning but WRHA says it means streamlined services and shorter wait times

The emergency room at Winnipeg's Concordia Hospital will become an urgent care centre starting Monday. (Darren Bernhardt/CBC)

As of Monday morning Concordia Hospital's emergency room is no more.

The space will operate as a 24-hour urgent care centre, part of Winnipeg's hospital reorganization plan, kicked off in 2017.

The move follows a whirlwind few weeks for the hospital and its staff.

The transformation of Concordia's emergency room into an urgent care centre had been planned for June 24, but at a press conference Wednesday, the province moved up the expected timeline of by three weeks, surprising unions and hospital staff.

Two weeks before that the province changed course on its original plan to turn the ER into an walk-in clinic.

Due to the short timespan, Concordia will maintain its critical care unit and keep acute beds until late June, as backup for patients who don't realize the ER has closed. 

Krista Williams, chief health operations officer with the WRHA, said Monday the transition went "seamlessly."

"There were no interruptions for patients. There were no periods of shutdown during that process," she said.

The health authority is still in the process of sorting out staffing at the centre, she said. Unions representing health-care workers at the hospital had raised concerns that staffing was in disarray last month.

"I want to be very clear that we're going to be monitoring this very closely to ensure that what we were projecting to see of individuals presenting to urgent care is the lived experience," she said.

Krista Williams, chief health operations officer with the WRHA, said 60 to 70 per cent of patients at Concordia's emergency department would be suited to an urgent care centre. (Lyzaville Sale/CBC)

The health authority has also worked with emergency medical services to ensure ambulances with patients who need treatment at emergency departments will be directed to the right place, Williams said.

Sixty to 70 per cent of patients who visited Concordia's emergency department would have been better suited to an urgent care setting, she said.

The changes at Concordia are part of an overhaul recommended in a report commissioned by the former NDP government in 2015 and completed by a team led by Nova Scotia-based consultant Dr. David Peachey.

The emergency department at Seven Oaks General Hospital is slated to be converted into an urgent care centre by September 2019 as part of the plan.

The province's new prescription for health-care delivery began last year, when it was announced that half of the city's emergency departments would close to consolidate emergency care at Health Sciences Centre, St. Boniface and Grace.

The revamp is meant to create operating efficiencies and cut wait times.

Harold Prosken, left, and wife Joyce Prosken said they were unhappy about the change. (Jaison Empson/CBC)

On Monday, Harold Prosken and wife Joyce Prosken were at Concordia for their son's hip replacement surgery. Both said they're unhappy with the change.

"Places like Health Sciences are getting swamped and they're shutting places like this down," Harold said. "I'm not happy with it, because people do deserve proper health health care."

He's concerned about added distance or confusion for people in health emergencies who previously would have used the hospital's ER.

"Time is a factor when you're fighting for your life," he said.

Why would they get rid of ERs? 

The vast majority of people who show up to Winnipeg's ERs don't even need "urgent" care, never mind emergency care, according to a 2017 report by the Manitoba Centre for Health Policy called Factors Affecting Emergency Department Waiting Room Times in Winnipeg. 

Hospitals use a scale of 1 (highly urgent) to 5 (non-urgency), and only 15 per cent of patients are triaged at 1 or 2. Around 40 per cent are rated "urgent" (3) and another 40 per cent as "less urgent," 4 or 5. 

Fed up with long wait times, more and more patients are leaving the ER before even seeing a doctor; the number reached 10 per cent in 2012-13, up from six per cent in 2004-05. 

When should I go to an ER?

So how do you know if your health issue is an emergency-room emergency? 

According to the WRHA, the ER is your best bet when you've got a life-threatening or potentially life-threatening condition, like severe chest pains, stroke or trauma.

The WRHA also provides a handy list of conditions that should definitely send you to the ER:

  • Heart attack
  • Stroke
  • Major trauma
  • Severe head injury
  • Loss of limb in an accident
  • Severe difficulty breathing (due to an allergic reaction or another cause)
  • Sexual assault
  • Domestic violence
  • Severe bleeding
  • Any time a person is unconscious

Emergency departments are open 24/7 on a walk-in basis, so you can go anytime.

A reminder: if you've got something going on that seems ER-worthy, you can also call 911.

When should I go to an urgent care centre?

This is the place for all those concerns that aren't life-threatening but do need to be taken care of right away. 

Fracture a bone? Need stitches? Severe flu symptoms? If your regular doctor's not available, get yourself to an urgent care centre.

Here are some reasons you might go to an urgent care centre:​

  • Fever or flu symptoms
  • Fractures or sprains
  • Minor burns
  • Headaches, earaches
  • Nosebleeds
  • Rashes
  • Sore throat
  • Urinary problems
  • Vomiting

Still not sure where to go? Call the 24-hour Health Links helpline at 204-788-8200, or toll-free at 1-888-315-9257.

What else does an urgent care centre offer? 

Staff can set and cast broken bones, clean and stitch cuts and provide counselling, just to name a few of the services available. You can also get crutches there for $25.

Specialists available include a physiotherapist, occupational therapist, dietitian, respiratory therapist, social worker and more.

Will this make my wait for care shorter?

WRHA services are spread too thinly across the emergency departments, according to the health region's website explaining all of the changes.  

"Having three emergency departments will allow us to concentrate our specialists and diagnostic services in fewer facilities, resulting in better access and shorter wait times," the website said. 

The Manitoba Liberal Party, meanwhile, said modelling and test runs should have been done to figure out how people would use the new emergency rooms and urgent care centres. 

NDP health critic Matt Wiebe previously said "when you close an emergency room in a community, that affects the care they receive."

Wiebe said he believes there is room to find efficiencies in the system, but closing ERs is not the answer. The report that first recommended the repurposing of emergency departments was commissioned by the NDP.

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