October 31, 2019
WRHA to focus on recruitment, patient flow following clinical reorganization
With the major clinical changes to Winnipeg’s health-care system now largely completed, the Winnipeg Regional Health Authority is taking steps to stabilize day-to-day operations across the newly modernized system, focusing on initiatives to increase the nursing workforce and improve patient flow.
The transition of Seven Oaks General Hospital to a low-acuity site, along with the closure of its critical care unit (ICU) in September 2019, effectively marked the completion of all the major components of the WRHA’s clinical consolidation changes, known as the Healing Our Health System plan. The plan was first announced in April 2017.
“These past two-and-a-half years have been a remarkable time of change in the Winnipeg Health Region, and I would like to extend a sincere thank you to all our staff and physicians, who lived through disruption, change, and uncertainty, yet always delivered professional, compassionate care to our patients, residents and clients, each and every day,” said Réal Cloutier, president and CEO of the WRHA. “Now that the major systemic and operational changes are behind us, our focus has turned to the stabilization of our newly modernized system.”
Cloutier confirmed that the system has already seen some positive indicators from the changes, such as a reduction in the number of people waiting for personal care home beds; an improvement in the median length-of-stay for patients admitted to hospital through emergency and urgent care departments; and a ratio of Alternate Level of Care (ALC) days that is now among the best in Canada.
Cloutier also acknowledged there remains work to do and emphasized that additional focus will be required in order to achieve improvements in areas like nursing recruitment and wait times. Filling nursing vacancies and improving patient flow will be significant factors in achieving improved wait times at emergency and urgent care departments, added Krista Williams, the WRHA’s chief nursing officer and chief health operations officer. The median emergency/urgent care wait time across Winnipeg hospitals in September 2019 was 2.07 hours.
“These wait times are not where we would like them to be, we know that we can do better and we are confident that we will,” Williams said. “People throughout our system have moved into new clinical areas and become part of new teams, and we know that with changes on this scale the adjustment to new clinical pathways and new routines will take time. But with some of the initiatives now underway and the feedback we are receiving from our staff, physicians and leaders, we are confident we will see improvement.”
Key to realizing those benefits, including making improvements to wait times, will be the efforts of two working groups that have been struck to focus on a nursing workforce strategy, and on improving patient flow by addressing a collection of issues commonly known in health care as “access block.”
The Nursing Workforce Strategy group is focused on identifying opportunities to improve the recruitment process, to remove barriers to external nursing candidates and to simplify the application and hiring process, wherever possible.
The access block working group is focused on developing strategies to flow patients without delay through emergency and urgent care departments, by removing barriers to in-patient admissions, reviewing discharge practices, and streamlining the processes for arranging patient consultations with specialists, among other initiatives.
“Every jurisdiction struggles with a variation of the access block challenges that we face here,” Williams said. “Now that the major transitions have been completed we can focus on the operational side of the change – creating and supporting the work and growth of new teams who will, in turn, improve the experience of our patients.”