WRHA announces details for next phase of health service consolidation

Winnipeg Regional Health Authority
Published Thursday, May 31, 2018

Building upon accomplishments already realized through the implementation of Phase I of our Healing our Health System plan, the Winnipeg Regional Health Authority (WRHA) announced details and timelines today for changes coming to the system during Phase II of the plan. The consolidation of health services is designed to improve wait times, ensure access to timely care for patients and support enhanced work environments for our staff.

“We have seen significant improvement already in the past six months since we began consolidation,” said Réal Cloutier, interim chief executive officer of the WRHA. “Overall we’ve seen a 15 per cent decrease in ED wait times year over year with our plan less than half-realized. We need to continue with our efforts and momentum to see further, bolder progress and improvement.”

A number of changes took place across the region during Phase I including:

• Victoria Hospital’s Emergency Department was converted to an Urgent Care Centre. Since then, wait-times at Victoria have decreased by nearly one third.
• Clinical assessment units opened at St. Boniface and Grace hospitals and the existing clinical assessment unit at HSC was expanded. These units support emergency department patients who need to be in hospital longer which frees up space and staff resources.
• Lab and diagnostic services were redeployed to ensure resources are available to best support patients where they are receiving care.
• A transitional care environment opened at River Ridge II for medically stable patients who are ready to be discharged from hospital but who require time to make long-term arrangements for their care. This facility operates regularly at capacity.
• Intensive home care services were introduced to patients who meet the criteria. Priority Home has seen more than 100 patients move through the program to date.
• Updated ambulance protocols were introduced last fall which have ensured paramedics are fully informed of the appropriate destination hospital, depending on the care required. In many instances, ambulance protocols remain the same. For example, St. Boniface Hospital remains the destination for most cardiac patients.
• The number of people waiting in hospital for placement into a personal care home is at an all-time low and regularly sits below 20 people.

The sequenced implementation of Phase II changes began earlier this month with the opening of Grace Hospital’s new emergency department. The re-designed department will treat more than 60,000 patients per year and supports Grace Hospital in its role as the region’s third acute care site, in addition to Health Sciences Centre Winnipeg (HSC) and St. Boniface Hospital.

Phase II will also see important renovations made to enhance the emergency departments at both HSC and St. Boniface Hospital. These renovations will be completed prior to the closure of Concordia Hospital’s emergency department in June 2019 and the conversion of Seven Oaks General Hospital’s emergency department to an urgent care centre in September, 2019.

These capital investments will increase emergency department capacity and improve treatment spaces. They will also concentrate resources – including staffing and specialized equipment – to accommodate more patients while ensuring timely access to the right care.

The region continues to pursue a detailed plan with Concordia Hospital to identify the health services that may occupy the Concordia emergency department space.

Phase II planning was informed by consultations with clinical leadership and health care staff, the George and Fay Yee Centre for Healthcare Innovation Interim Evaluation of Phase I and the recommendations of the Wait Times Reduction Task Force Report. Several aspects of the Phase II plans and targeted timelines were adjusted as a direct response to this feedback.

Phase II highlights offered today included a timeline for the consolidation of mental health Services at Victoria Hospital (complemented by existing resources at HSC and St. Boniface Hospital). The consolidation of in-patient mental health services across the region is expected to be complete within winter 2018 and will see 52 beds relocated to Victoria Hospital to expand on-site treatment and counselling spaces and improve on-site access to psychiatrists.

Summary of other changes coming in Phase II

Enhancement of Cardiac Services

• Acute Cardiac Care Unit will open at St. Boniface Hospital to increase capacity (adding two beds to make 10).
• The number of beds on the inpatient cardiology unit at St. Boniface will increase from 32 to 48 to consolidated cardiac care at St. Boniface to ensure each patient has the care they need most.

Community Intravenous Program

• This community IV service will move from its existing location at Lions Place to the former site of urgent care at Misericordia Health Centre in September 2018 (item remaining from Phase I plans).

Emergency Departments

• Grace Hospital emergency department – new department opened May 29, 2018.
• HSC will expand emergency department to open a mid-to-low acuity area of treatment – January 2019.
• Concordia Hospital emergency department will close – June 2019.
• The expansion of the St. Boniface emergency department continues, with new triage, waiting area and mid-acuity treatment space opening spring, 2019.
• Seven Oaks General Hospital emergency department will transition to an urgent care centre – September 2019.
• St. Boniface emergency department renovations will be completed, with renovated high-acuity and resuscitation space opening summer 2019.

Intensive Care Units (ICU)

• Services will shift out of Concordia and Seven Oaks General Hospital (in Spring and Fall of 2019 respectively) to HSC and St. Boniface Hospital at the same time as the changes to their emergency departments are made.
• HSC intermediate expansion of ICU takes place September 2019.

Medicine

• Concordia Hospital and Seven Oaks General Hospital will shift capacity and focus to less serious community hospital care and transitional care services beginning in 2018.

Mental Health

• Mental Health will consolidate from Grace and Seven Oaks General Hospital into HSC, St. Boniface and Victoria General Hospitals in December 2018.

Surgery

• HSC Surgical ICU will expand in August 2018.
• Surgical slates will shift from Seven Oaks General Hospital to other sites in January 2019.