The Emergency Department (ED) at the Chesley site of South Bruce Grey Health Centre (SBGHC) will be moving to reduced operating hours due to a nursing
Starting Saturday, September 21, 2019, the Chesley ED will be only operating from 8:00 AM to 8:00 PM, and will be closed overnight from 8:00 PM to 8:00 AM. The reduced hours of service for the ED are a temporary measure, and will extend until Saturday, February 1, 2020, at which time the nursing staff complement will be evaluated to ensure it has been stabilized enough to reopen 24/7.
The nursing staffing challenges are not new, but have escalated over the last week due to the unexpected extended leaves of one full-time RN and one full-time RPN. For several months, the Chesley site ED has experienced significant difficulty filling short notice shift vacancies. Efforts have been made to replace shifts with part time nursing staff, nursing staff from other sites, and clinical managers. Although several nurses have generously offered to fill and/or trade shifts, a number of unfilled shifts remain over the coming weeks and months.
The current situation is not sustainable, and as a result, alternative options for ED service provision were explored, to be implemented until the staffing complement is stabilized.
1. Full closure of the ED
2. Weekend closure of ED from Friday at 2000 until Monday at 0800
3. Daily closure of ED from 2000 to 0800
4. ED Open 24/7
The decision to move to reduced operating hours was made by the SBGHC Board of Directors at a special meeting on August 27, 2019. This decision was based on a recommendation which came from a working group consisting of Chesley Site Chief Dr. Jacqui Wong, SBGHC Chief of Staff Dr. Lisa Roth, Chief Nursing Executive Maureen Rydall, Chesley Patient Care Manager Stephanie Metcalfe, Chesley Physician Recruitment Committee Chair Sharon Musehl, President and CEO Michael Barrett, and Chesley physician Dr. Adam Winterton, who have been meeting daily to evaluate options for ED service provision moving forward.
QUALITY HEALTH CARE – CLOSE TO HOME
Of the four options considered, moving to reduced hours in the ED has the least impact on patients, as 85% of the visits to the Chesley ED come during the hours between 8:00 AM and 8:00 PM. Typically, the volume of patients seen in the Chesley site ED during the overnight hours are very low, and in some cases there are no patients seen in the overnight hours.
As part of the analysis of option 4, SBGHC explored the use of nursing agencies to keep the ED open 24/7, however, these agency nursing resources were also not available.
“Moving to reduced operating hours in the Emergency Department is not an option that we wanted to pursue, but based on our assessment, the current situation cannot be sustained. A temporary reduction in ED operating hours will ensure the Chesley ED can effectively deliver emergency care from 8:00 AM to 8:00 PM, and also provide time for SBGHC to stabilize its nursing pool in Chesley,” explains Michael Barrett, President and CEO.
Recruitment and retention of Registered Nurses (RNs) and Registered Practical Nurses (RPNs) is very challenging in rural communities. Nurses are required to develop a high degree of competency in a number of clinical domains and specialties, and new graduates can often be unprepared to work in a rural setting without significant orientation and mentorship.
South Bruce Grey is committed to keeping all four of our sites strong and viable. This commitment is evidenced by the ongoing construction project in Chesley where $2.7M is currently being invested in new air handling equipment and a full sprinkler system, and additional community funds have been directed to significant internal renovations in the ED and inpatient unit.
SBGHC will provide more information over the next 2 weeks to ensure the Chesley community is informed about this decision, and ensure residents can make informed choices about their emergency health care. A community information session has been scheduled on Wednesday, September 11 at 6:30 PM at the Chesley Community Centre.