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Bird's eye photo of a hospitl waiting roomLetter from the Region
Preparing
for change

Realignment of services will
lead to better care
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Réal Cloutier
President and CEO
Winnipeg Regional Health Authority
Mar/Apr 2019

We're now about two months away from beginning to implement the first of two major changes outlined in the final phase of our plan to realign the way we deliver health-care services.

And that means it's probably a pretty good time to take stock of what we have achieved so far, and talk a bit about what our patients and clients can expect going forward.

As most readers will know, the Winnipeg Regional Health Authority launched the Healing Our Health System plan about two years ago in April, 2017 with a view to realigning the delivery of services to provide better care. Since then, we have completed the first phase of the plan, which included a restructuring of services at Misericordia Health Centre and Victoria General Hospital, and adding community options to increase support for seniors to live in the community longer.

Preparations for the second and final phase of our blueprint for change began last year with the development of plans to restructure the delivery of services in several areas.

Some of these plans have already been implemented or are close to being completed. They include initiatives to consolidate mental health services at Health Sciences Centre Winnipeg, Victoria and St. Boniface Hospital, enhance cardiac care at St. Boniface, open a community intravenous clinic at Misericordia, and change where surgical procedures are provided.

Other changes in phase two are yet to come, and involve transitioning the emergency department at Concordia Hospital into a Walk-In Connected Care clinic and converting the emergency department at Seven Oaks into an urgent-care centre. The first of these changes will take place at Concordia in June, followed by the conversion of the emergency department at Seven Oaks, which is expected to take place in September.

Steps have already been taken to ensure the transitions at both hospitals go as smoothly as possible. For example, the emergency department at St. Boniface is being renovated to expand capacity to serve more patients, including those from the northeast part of the city. The first phase of construction was completed in March, and the second phase - which increases the cardiac monitoring spaces - will be completed in June. A further improvement to create a mental health assessment area will be completed in early fall 2019. The total cost of enhancements at St. Boniface will be about $5 million.

We will be bolstering staffing at St. Boniface, with approximately 30 emergency department staff from Concordia moving to St. Boniface as part of the restructuring. There will also be additional physicians on duty. Meanwhile, hospital and clinical leadership teams continue working to ensure we are on track with all issues relating to equipment, technology and information systems, supplies, and patient transportation. And all of this is being done with a view to ensuring we meet our standards for quality and patient safety.

Plans to turn some of the emergency department space at Concordia into a Walk-In Connected Care clinic are also proceeding. At this time, it is expected that services at the clinic will be provided by nurse practitioners and doctors. More information about the clinic will be shared as planning is finalized.

Steps are also being taken to ensure HSC Winnipeg and Grace Hospital can handle increased traffic with the changes at Concordia and Seven Oaks. We have spent about $43.8 million on a new emergency department at the Grace, one which is three times the size of the old one and capable of handling 60,000 people a year. Work has also been completed on a $1.2-million enhancement of the mid- to low-acuity treatment area at HSC Winnipeg, and efforts are being made to ensure both facilities have the physical space they need to handle any increase in patients seeking emergency care. Additional staff and physicians will be added to HSC Winnipeg and Grace as these changes occur to ensure that we have the staffing necessary to care for the increase in patients.

One of the key issues in realigning services in an organization as large and diverse as ours is working with our staff as these changes occur. The effort to reorganize services across our facilities naturally means that jobs will shift from one site to another. We respect that staff can make the decision as to whether they will move along with the job. In some cases, a health-care provider or support staff member working in one part of the city may not want to follow their job to another location. And those who aren't interested in transferring may decide to take another job within their current facility. This sometimes creates a vacancy that can't easily be filled on short notice. We are conscious of these challenges and are working to develop various options that will help mitigate potential problems should they occur. We appreciate this is a big change for our staff and physicians and appreciate their continued dedication to patient care.

So yes, there are challenges involved in a major undertaking of this kind. And no, things don't always go exactly as planned. But at the end of the day, it is important not to lose sight of what we have been able to achieve over the last two years.

When we first launched the Healing Our Health System plan, it was with the intention of fixing a broken system, one that was not operating efficiently or effectively. Since then, we have moved to improve and enhance access to services in a number of areas, including emergency and urgent care, cardiac care and mental health. We have also added additional community capacity, which has resulted in a historic low in the number of patients in hospital awaiting long-term care. The result of all these changes has been, despite some recent setbacks, the slow, but steady improvement in various performance indicators, including emergency department wait times. In other words, we are well on our way to creating a better health-care system, one that will provide our patients and clients with the care they need and deserve.