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Shared Health has released the quality assurance assessment commissioned to review Phase II of the Winnipeg Regional Health Authority’s (WRHA) clinical consolidation, announced Dr. Brock Wright, chief executive officer, Shared Health, earlier today.

The review is in line with Shared Health’s mandate to implement clinical leadership and governance in order to support continuous improvement in quality of care and patient safety and was conducted by Dr. David Peachey of Health Intelligence Inc.

“The completion of quality assurance assessments in advance of clinical changes is a leading practice in jurisdictions across Canada,” said Wright. “The need to conduct a rigorous assessment of the plans for Phase II as well as the achieved and anticipated outcomes related to clinical consolidation became evident through discussions with clinical leadership as concerns were raised about the ability to safely manage medical and surgical care across the region within planned timelines.

“Close monitoring of outcomes and a willingness to adjust plans and timelines in accordance with clinical advice will be an important role of Shared Health as we build a robust clinical governance structure.”

The quality assurance assessment included a quantitative review of health system data and indicators along with several meetings with clinical leadership from Shared Health and the WRHA to evaluate the progress of consolidation plans. Meetings were also held with front-line nurses and the Manitoba Nurses Union (MNU).

Peachey’s review identified broad support, with the exception of MNU, for the overall plan to consolidate clinical and diagnostic services at fewer sites to ensure improved access and quality of care, but concerns were raised across the majority of the meetings about the timelines and execution of the plan as well as the absence of a timely risk assessment.

The report makes a number of recommendations, chief among them the need for a provincial clinical governance model to support healthcare delivery. It also recommends the monitoring of changes across the province to ensure desired outcomes are being achieved or if adjustments are needed to address changes in acuity and volume. Specific recommendations have already been implemented, including the creation of an urgent care centre at Concordia Hospital along with the completion of a bed map review.

“The quality assurance assessment was an important part of ensuring we get the changes being made across our health care system right, and we appreciate the recommendations Dr. Peachey has put forward,” said Réal Cloutier, president and chief executive officer, WRHA. “We are working closely with Shared Health as well as with clinical, physician and site leadership and staff to ensure the changes we are making result in better health care – sooner – for our patients; now and for generations to come.”

The report also identifies a number of achievements including improvements to emergency department wait times, historic low wait times for personal care home placement in Winnipeg and improvements associated with the consolidation of mental health and surgical services.

“Patients are – and will remain – at the centre of our development of a provincial clinical and preventive services plan for Manitoba,” said Wright. “Clinical planning of acute services, including the work being done through the WRHA’s clinical consolidation, is an important foundational step to improving the access, quality and consistency of care for Manitoba patients.”