At a special meeting on December 17th, 2021, the South Bruce Grey Health Centre’s (SBGHC) Board of Directors approved a reduction of services at the hospital due to nursing staff shortages.
Starting Monday, December 27th, 2021, the Walkerton hospital Emergency Department (ED) will be closed overnight from 8:00 PM to 8:00 AM, operating from 8:00 AM to 8:00 PM for an indefinite period. In addition, the Inpatient Unit at the Chesley site of SBGHC will be converted to a 20-bed Alternate Level of Care (ALC) Unit for an indefinite period to allow for an alternate staffing model to be used with less RNs required. ALC patients no longer require acute care and are awaiting placement in the community (i.e. long-term care, group home, home with home care supports). SBGHC’s Chesley site currently has 10 Seniors Centre of Care beds that care for this patient population.
SBGHC has been facing significant shortages in health human resources (HHR) for over 5 years, particularly in nursing. SBGHC has already reduced the hours of operation for the Chesley hospital Emergency Department (ED) in September 2019 due to nursing shortages.
There is an overall shortage of nurses in the province, which is being compounded by burn-out after 20 months of navigating the pandemic, the unique nature of rural nursing practice, a younger work force that has resulted in a large number of maternity leaves, and more nursing opportunities available across the system that provide a more attractive schedule (i.e. Monday to Friday without evenings and weekends).
With three recent RN departures impacting the current nursing schedule, SBGHC is facing critical nursing shortages over the holiday season, and well into the new year. SBGHC does not have enough staff to provide the current level of service as evidenced by the fact that there is a large number of unfilled shifts in the upcoming nursing schedule starting January 2nd, 2022.
“We have had several close calls over the last 6 months where we almost had an unplanned emergency department closure, and it has become clear that we will not have enough staff to continue to operate at our current level of service,” explains Michael Barrett, SBGHC President & CEO. “I must emphasize that we have only been able to keep services open to date based on the good will and hard work of our front line staff and managers, and this situation is not sustainable.”
“There are some non-negotiables that we must consider. We cannot provide care in a manner that is unsafe, and we cannot provide care that further deteriorates our staff, so there are choices required,” says SBGHC Board Chair Bill Heikkila. “We must implement choices that have the least harm, provide the greatest benefit to the community with the resources we have available, and ensure equity and fairness for four strong viable hospital sites across SBGHC.”
To achieve a sustainable staffing model in the short-term due to immediate challenges, 12 options for service reductions across the organization were reviewed, and narrowed to four for further consideration by SBGHC’s leadership team and Board of Directors.
These options ranged from complete closures of programs and services, to modification and reductions of service levels. In the evaluation of the options, the Board wanted to ensure that the care provided at the hospital is safe and does not further deteriorate our staff. In addition, the Board wanted to ensure that key programs like the Family Birthing Centre, where mothers deliver over 450 babies annually, was protected.
Of the options considered, moving to reduced hours in the Walkerton ED has the least impact on patients, as 82% of the visits to the Walkerton ED come during the hours between 8:00 AM and 8:00 PM, and there are five alternate EDs open 24/7 within 51 km of Walkerton. Combining the ED closure with the designation of the Chesley Inpatient unit frees up enough staff to fill vacant shifts, and allows for a small contingency for sick calls and patient transfers.
“Our Board’s difficult decision to reduce services to address staffing challenges in the short term is unfortunately only a band aid,” explains SBGHC Board Chair Bill Heikkila. “A longer term solution will require system planning with our hospital partners from across Grey Bruce and the larger South West region.”
The reduced hours of operation for the Walkerton hospital ED will take effect on Monday, December 27th at 8:00 PM, and will continue indefinitely. Patients requiring emergency care during the hours of 8:00 PM to 8:00 AM should present to one of the neighbouring 24/7 EDs, or call 911 to be taken to the nearest 24/7 ED.
Hanover & District Hospital
12 KM from Walkerton
South Bruce Grey Health Centre – Durham
320 College Street
28 KM from Walkerton
Wingham & District Hospital
270 Carling Terrace
39 KM from Walkerton
South Bruce Grey Health Centre – Kincardine
1199 Queen St.
43 KM from Walkerton
Palmerston & District Hospital
500 Whites Road
Grey Bruce Health Services – Southampton
340 High St.
51 KM from Walkerton