Phase 2 Consolidation – Fall 2018 Changes and Labour Adjustment - Nurses Tuesday, September 11, 2018 Phase 2 Changes – Fall 2018 Mental Health •Move of services from Grace and Seven Oaks to Victoria Hospital in early December, 2018. Surgery •Movement of various surgical activity beginning in September with final closure of surgical services at Seven Oaks in January, 2019. Master Rotations •Changing master rotations to better match patient needs. Benefits of Consolidating the Surgery Program • Peachey Report indicated that specialty services, including surgery, were spread too thinly across too many sites to be able to improve access for patients. • Consolidation of surgical expertise and equipment improves patient outcomes and is more efficient. • No reduction in the numbers of procedures. • Creates opportunities to address long-standing waitlist issues. • Focus on best practice including increasing day and short stay procedures. • Opportunity for jobs to move along with procedures. Benefits of Consolidating the Mental Health Program • Plan consolidates inpatient mental health services at three hospitals: HSC, St. Boniface and Victoria. • Concentrates psychiatric expertise and improves on-site treatment and counselling facilities. • Services are currently characterized by long waits to access services, and gaps in the continuum of care. • Plan also includes improving coordination between acute hospital and community-based mental health services. Mental Health Continued • New patient pathways will be introduced for patients who present in Emergency and Urgent Care Departments. • Psychiatric Liaison Nurses and Consult Liaison Psychiatric Services will continue to provide service to all sites to support effective access to mental health services across all hospitals. • Telehealth services will be enhanced to support timely access to assessment and treatment services and will reduce patient transfers between sites to access services. • Bringing mental health resources together will limit the number of hospitals patients may visit in their time of need and offer them more streamlined, seamless care. Capital Update • HSC ED Renovation – January 2019. • Mental Health Unit – November 2018. • The construction contract has been awarded for the redevelopment and expansion of the Emergency Department at St. Boniface Hospital. • The contractor is currently mobilizing on site. • The work will occur in phases (“parts” below) in order to accommodate existing patient services. • The ED will continue to remain open and provide excellent patient care throughout construction phases. Capital Update Continued Part One – Demolition completed in June, 2018. Part Two - Construct a new waiting room, triage, rapid assessment bays, consultation area and exam rooms. Scheduled to be open to the public in spring 2019. Part Three - Renovate some of the existing treatment bays, and add an additional resuscitation area. Scheduled to be open in summer 2019. Part Four - Expand the mental health-specific area in ED. Scheduled to be open in fall of 2019. Our Commitment to Staff • The WRHA has committed that every nurse who wishes to continue working in the region will be able to do so. • New positions available at other hospitals as a result of consolidation of programs supports this commitment. • Vacancy rates across the region also give us confidence we can meet this commitment. • Discussions are already underway with affected staff, as they told us in Phase 1 that they wanted to hear about the changes from their leaders rather than in public. • Efforts to provide more certainty for staff throughout the process. Collective Agreements • The WRHA is party to collective agreements with each union group we work with. • These agreements: – Outline many terms and conditions of employment. – Protect employees in the event of changes to their position, shift rotation, or their EFT status (Equivalent to Full Time). – Include timelines for official notice of changes, rules for obtaining a new position, and the ability to displace (or “bump”) someone else in within the same union group where an employee is qualified to do the work. Meetings Between the Region Unions and • Throughout the summer, WRHA, HR and Provincial Health Labour Relations Services have been meeting regularly with health sector unions. • Purpose was to discuss the changes and negotiate agreement on labour adjustment strategies – before formal notification has been given. • Worked together to address lessons learned from Phase 1. • Based on feedback following Phase 1, nurses and support staff will receive a significantly longer notice period going into these adjustments. Employment Security Notices • Formal start to the process. • Provided to a union by an employer to signal intent to implement changes that will affect staffing. • Typically provided at least 90 or 120 days in advance of the change, depending on the collective agreement. • Many of these Phase II notices are planned for longer time periods. • This will allow more time to plan and implement the process, providing certainty for staff well in advance of implementation dates. Position Deletion Notices • Do not signal layoff. • Required by the collective agreements to signal to the staff member that his/her current position will no longer be available in the same way. • Provided to each affected staff member in writing. • Initiates the process that enables nurses to choose their preferred option following any change to their position. Upcoming Labour Adjustment Activities Employment Security Notices •Have been given to impacted unions at Grace Hospital and Seven Oaks General Hospital in the last few weeks. •Are planned for unions at other hospitals with Phase II activities in the coming weeks: HSC and Concordia. Meetings with Unions and Staff •Productive meetings continue to share details and plan the process to be used for the Grace Hospital and SOGH changes; most related to the surgery and MH consolidation. Upcoming Labour Adjustment Activities Position Deletion Notices •Will be issued in the coming weeks to affected staff at Grace Hospital and Seven Oaks General Hospital. •As the process continues with other hospitals, position deletion letters will follow. Program Transfer Selection •Nurses with program transfer opportunities within surgery and mental health will be able to participate in the program transfer selection process and only if an opportunity at another hospital is not selected will a position deletion notice be given. •In Phase I, approximately 80% chose to move with their program, rather than stay at their hospital. Rotation Changes • In addition to program consolidation, many of the changes associated with Phase II require rotation changes. • Rotations are changed to ensure stable staffing through the entire week and to ensure the right mix of staff, depending on patients in the unit. • With some units expanding to accommodate additional beds or with units serving a different patient population, rotations also need to be adjusted. Physician Plan for Surgery and Mental Health • Discussions for several months with surgeons and psychiatrists. • Ongoing discussions with Doctors Manitoba. • Important that we engage physicians in all of our planning. Health Authority sant? de Winnipeg Healing our Health System CARING Winnipegaegm. omcer?gionamua Rl?Hl llME. HIBHT PLAEE. FOR HEALTH Caring for Health A l'?coute de notre sant?