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This article was published 31/1/2018 (965 days ago), so information in it may no longer be current.

An evaluation of the first three months of the Pallister government's hospital re-organization plan shows that patient wait times have improved and hospital stays have been reduced without precipitating any major health care quality or safety concerns.

The 60-page report, released Wednesday, said Winnipeg emergency rooms and urgent care centres reduced median wait times an average of 19 per cent over the previous year.

Median waits for ER patients requiring a hospital beds fell by 14 per cent. Once admitted to hospital, they were discharged sooner.

The report, prepared by the Winnipeg Regional Health Authority in conjunction with the George and Fay Yee Centre for Healthcare Innovation, said most of Phase 1 of the clinical consolidation plan that began Oct. 3 was implemented on schedule.

The biggest changes included the closure of the Misericordia urgent care centre and the conversion of the Victoria General Hospital's emergency room into an urgent care centre.

One of the reasons for the improvement in hospital patient flow efficiency was the creation of a unit at Victoria hospital to deal with "sub-acute" patients. These are patients — often elderly with multiple health issues — no longer require acute care but need more time in hospital before they can be released. They used to be interspersed with more seriously ill patients throughout the hospital system but are now concentrated in one spot.

However, these sub-acute beds are constantly full, and there have been as many as 40 patients waiting in acute care beds for these spots, "creating a new bottleneck in the system." The report said more of the beds are needed "as soon as possible."

It also said better communication was needed so that staff understood their new roles. Health care staff said they learned about changes being implemented in Phase 1 primarily from the media.

"Information was not given to staff until the last possible minute. Staff had no voice," said a health worker quoted in the report.

Better communication between hospitals and patients is also needed. The report cited instances where patients being transferred from an acute care facility to sub-acute beds at Victoria hospital were given no advance warning.

Health Minister Kelvin Goertzen acknowledged Wednesday that the health system needs to do a "better job" in communicating the changes being implemented.

BORIS MINKEVICH / WINNIPEG FREE PRESS Lori Lamont, Acting COO, Vice President, Nursing and Health Professions said the report "reinforces that there is more work to do."

He said the government is not in a rush to implement Phase 2 of the plan, which will include closing the ER at Concordia Hospital and converting the ER at Seven Oaks General Hospital to an urgent care centre.

"We're not driven by specific timeframes," Goertzen told reporters, adding that further reform won't be carried until the system is ready for it. "That will continue to be for me as the minister of health my guiding principle," he said.

A timeline for the implementation of Phase 2 is expected to be announced around the end of March, he said.

Labour leaders representing health care workers took issue with the generally positive evaluation of the first three months of hospital reform.

"This report is inconsistent with what we’re hearing from nurses working on the front line every day," said Sandi Mowat, president of the Manitoba Nurses Union.

"Nurses are telling us that emergency departments are often overcrowded and chaotic, patients are being treated in hallways, and that acute patients are being admitted into sub-acute units. With the increase in patient volumes, security is increasingly becoming a source for concern as well. We’re worried safe patient care is being jeopardized," she said.

Debbie Boissonneault, president of CUPE 204, which represents 7,000 health care workers, mainly in Winnipeg, described Phase 1's early implementation as "nothing short of chaotic."

She said her union, which represents clerical staff, occupational therapists, physiotherapists, health care aides, administrative and custodial workers among others, has experienced job cuts. Many frontline workers are also working fewer hours, meaning there is less contact between staff and patients, she said.

Lori Lamont, the WRHA's vice-president of nursing and acting chief operating officer, said while there have been improvements in system efficiency over the last few months, the report "reinforces that there is more work to do."

Among the challenges is a December increase in the number of so-called 'board patients' -- those who wait longer than 24 hours in the emergency department.

There was also a fairly high hospital readmission rate for sub-acute patients -- 21 per cent -- during the three month period. Normal hospital readmission rates (within 30 days of discharge) is in the 14-16 day range in Winnipeg.

"It's a short time frame and a small sample...," Lamont said by way of explanation. She said the health authority has not previously tracked this new category of patient.

The report, Interim Evaluation of the Winnipeg Regional Health Authority's Healing our Health System Plan, is available on the WRHA's website. The Centre for Healthcare Innovation, which co-authored the report, counts the WRHA as one of its partners.

larry.kusch@freepress.mb.ca