Health system focused on tying community supports to long-stay inpatients

Winnipeg Regional Health Authority
Published Thursday, July 27, 2023

A number of initiatives to improve patient flow and bring down wait times are ongoing at Winnipeg hospitals, including the creation of a clinical working group that focuses on ensuring long-stay inpatients get the supports they need to safely transition back into the community, Shared Health and the Winnipeg Regional Health Authority reported today.

"We know people do best when they are able to recover at home, in their own environments. Our commitment is always to work with patients and their families to achieve this goal," said WRHA CEO Mike Nader. "The efforts of the working group have been invaluable in assisting patients to transition to the most appropriate care environment while also supporting efforts to improve our long-standing patient flow issues."

There are approximately 1,500 patients in the system that are unable to transition to a bed as quickly as they could have, often due to the complexity of the required community services they need. The long-stay working group meets biweekly to review long-stay patients on a case-by-case basis to determine if they could be appropriated cared for in the community and work to set up the necessary supports they need to do so.

Since the group began its work in March, teams across all sectors of the health system have worked together to discharge 287 long-stay patients. These 287 patients represent a total savings to the health system of 39,178 inpatient days.

Other ongoing initiatives to improve patient flow and lower wait times include the new minor treatment clinic at HSC Winnipeg. The clinic is scheduled to open on Aug. 9 and will primarily serve a neighbourhood population that often has less urgent concerns. The clinic will be open daily from 10 a.m. to 10 p.m. on a strict referral-only basis from HSC's adult emergency department.

"We know there are a number of low-acuity patients who live close to HSC, don't have a family doctor and have difficulty travelling to other locations for health care," said Dr. Shawn Young, HSC Winnipeg's chief operating officer. "This clinic will ensure these individuals get more timely and appropriate care, reducing both the number of people waiting in the emergency department as well as the number of patients who leave without being seen."

A number of other initiatives are ongoing or been implemented, including the displaying of real-time waits at all Winnipeg EDs, urgent care centres and walk-in connected care clinics on screens for patients in hospital waiting rooms. These and other patient flow projects have been supplemented by the health human resources action plan, which aims to address staffing challenges by focusing on retention, recruitment and training.

Emergency and urgent care metrics for June are below:

• Median waits were 2.87 hours across Winnipeg emergency departments and urgent care centres. This is unchanged from June 2022 but up 14 minutes from last month;
• Ninetieth percentile waits were 7.2 hours, which is up about 10 minutes from May but down nearly eight minutes from 12 months earlier;
• The median length of stay for patients in emergency or urgent care who were awaiting admission to an inpatient unit was 18.22 hours, which is a nearly 46-minute improvement from May and a 200-minute improvement from 12 months earlier;
• The overall left without being seen (LWBS) rate was 14.2 per cent in June, which is up slightly from 13.8 per cent the previous month but down from June 2022, when the rate was 16 per cent. The LWBS rate at HSC Winnipeg was 29.3 per cent in June, which is up one per cent from May but down slightly from June of last year, when the rate was 29.5 per cent; and
• Daily patient volumes remained static from May, with an average of 815.9 visits per day to emergency and urgent care. The number of patient visits to emergency or urgent care are up 2.1 per cent from June 2022.

Patients are reminded to seek help in an emergency, either by calling 911 or going to an ED or urgent care centre. All patients are assessed and triaged upon arrival and care is provided, with the sickest and most injured patients prioritized. Those with lower acuity concerns can expect longer waits. Monthly ED/UC wait time data, as well as an FAQ, is available here.