More details are beginning to emerge from the Winnipeg Regional Health Authority’s hospital reorganization plan, including confirmation the WRHA plans to contract out its new “enhanced” home care program.

The WRHA announced the hospital revamp plan in April, which includes the shutting down of three emergency rooms in the city. As part of the plan, the WRHA is moving ahead with a number of initiatives to free up more medical beds within hospitals to help reduce ER overcrowding. And that includes the creation of a new $16-million-a-year enhanced home-care program designed to move more long-term patients out of hospital and into their homes, which the WRHA has now confirmed will be contracted out.

“We are initially going to go out to a third-party provider to provide the enhanced home care service for us,” Lori Lamont, the WRHA’s vice-president of inter-professional practice, told the Winnipeg Sun Tuesday. “We’re going to contract that out.”

The new home care program is expected to employ about 200 service staff. It will operate separately from the WRHA’s regular home care service and is designed to provide long-term care patients in hospital — many of whom may be waiting for a spot in a personal care home — with more intensive care at home.

“It’s really to try to move some of that decision making around long-term care placement out of hospital into the community and give people some time in their own environment with additional support in order to hopefully successfully be able to remain at home,” said Lamont.

“We expect that when this service is in place we’ll have more people able to make the transition into long-term care from home than currently happens from hospital.”

About two-thirds of people placed in personal care homes come directly from hospital, according to the WRHA. But that’s often following lengthy hospital stays which reduce the availability of medical beds for new patients coming into hospital, including from ERs. Emergency room overcrowding often occurs when patients are admitted to hospital but have to wait in the ER treatment area because there’s no medical bed available for them.

The new enhanced home care program, which Lamont says has been used successfully in Ontario, will provide people with up to 90 days of intensive care in their homes. Some may remain in their homes with regular home care following the 90-day period, others may require no further care and some may be placed in a personal care home, said Lamont.

The WRHA says it’s contracting out the service because regular home care will be undergoing a number of changes and improvements, including to scheduling.

The WRHA will continue to use its own nurses for the new program through the creation of a specialized team of nurses. And case co-ordination and decision making will remain with the WRHA. But the home care attendants themselves will be contracted out, said Lamont.

The program is expected to be in place within the first phase of the hospital reorganization plan.

“We’re just in the process of getting that request for proposal out to the marketplace,” said Lamont.

The WRHA says it will evaluate the new program over the next three years to see whether it should continue to be contracted out or whether it should be done in-house. Either way, it will become a permanent part of the WRHA’s home care service, said Lamont.

The Manitoba Government and General Employees’ Union, which represents government home care workers, won’t like the plan. They’ve already complained about the contracting out initiative last month when they got wind of it from WRHA brass.

But if this can help free up more medical beds and help transition people more effectively to their homes — and who knows, maybe even do it cheaper than government home care — then why not?

It may be what’s needed within a larger plan to reduce emergency room overcrowding.

WRHA adding transitional beds to improve patient flow

Home care isn’t the only thing the Winnipeg Regional Health Authority plans to contract out as part of its hospital reorganization plan.

In an effort to free up inpatient beds in hospitals, the WRHA plans to fund 65 new transitional beds for long-term care patients outside of hospitals. And they’re looking for a private provider to house them.

“We actually have a (request for proposal) that’s out this week,” said Lori Lamont, the WRHA’s vice-president of inter-professional practice.

The new unit would accommodate people waiting for a personal care home bed who may otherwise be occupying a hospital bed. It may also be used for those whose living situation isn’t suitable for the WRHA’s new enhanced home care program.

It’s one of many steps the WRHA says it’s taking to free up medical beds in hospitals to improve patient flow and to reduce ER overcrowding.

Meanwhile, Lamont says additional inpatient beds will also be added to the three hospitals that will be keeping their emergency rooms, namely Grace Hospital, Health Sciences Centre and St. Boniface Hospital. Up to 138 hospital beds currently used for other purposes at those facilities, like rehabilitative care, will be switched to acute care beds. The services currently provided in those beds will be transferred to community hospitals.

Lamont also says the WRHA continues to work towards reducing lengths of stay for hospital patients generally.

“We know that for most conditions, people in Winnipeg stay (in hospital) longer than they would in other parts of the country,” said Lamont. “We expect that we can free up inpatient capacity by reducing that length of stay.”