A long time West Island community activist and the head of Quebec’s most active patients’ rights group have some reservations.
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It’s wonderful to hear the much-maligned emergency ward at the Lakeshore General Hospital is being replaced, which will hopefully lead to marked improvement in care. The project starts with the installation of a prefabricated modular building that will serve as a temporary measure until the construction of a new three-storey ER building, scheduled to open in 2028.
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However, a longtime West Island community activist and the head of Quebec’s most active patients’ rights group have some reservations.
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Community activist Sheila Laursen — who sat on the board of the former West Island health and social services centre — said the LGH’s ER has for decades been too small and under-resourced. It’s been unable to handle the number of people seeking emergency help as the populations of the West Island and the adjacent Vaudreuil-Soulanges region have grown dramatically since the hospital opened in 1965.
“I remember hearing that the hospital’s capacity, the ER in particular, could not meet the needs of the population when I first served on the board of CLSC Lac-St-Louis back in 1989,” Laursen recalled.
Repeated calls for a new ER from when she later served on the local health centre board went unheeded then from the health ministry, she added.
“I have been grateful for the good care I have received when needed (at the LGH), and I have been dismayed when situations of poor care or unacceptable treatment have hit the news headlines,” Laursen said. “As a former nurse (long ago), I grieve for the health-care workers of today — trying to provide care in over-filled, over-crowded facilities in local hospitals like the Lakeshore. Their pleas have been ignored and they have not received the attention or funding they deserve to provide the necessary first-line emergency and general hospital services that their growing populations need, and should receive locally.”
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Laursen is pleased a modular unit will be installed in the coming months, and she hopes the province comes through with funding to construct a new permanent ER at the LGH.
“The population of the West Island needs this, deserves this and has waited far too long for action,” she said.
Paul Brunet, executive director of the Conseil pour la protection des malades, said a new ER facility at the LGH is only part of the solution to improve the health-care network, pointing to calls for more home care for seniors and better access to clinics.
“Renovations or a new building are always nice, and to provide better ambiance for patients and personnel is certainly a good thing. But are they going to improve the management? Because poor Lakeshore has been (criticized so much) in the news for the past couple of years,” he said.
“I’m asking: Will that improve the number of personnel, will this change the way we treat people at the emergency?” Brunet added. “You have to stop treating patients or welcoming them (to the ER) when they don’t need emergency care, and start treating them and sending them elsewhere.”
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The province must work on tackling the root causes of ER overcrowding and introduce measures to significantly lower the number of ambulatory patients, Brunet said.
“Why are so many patients still ending up in the emergency ward?”
The shortcomings of the LGH’s ER department have been publicly highlighted in the past year or so. A report in 2022 by independent mediator Marie Boucher, dealing with a labour impasse with nurses and management, stated that due to staff shortages, the LGH’s ER was a “ticking time bomb.”
A report tabled this June by government investigator Francine Dupuis contained 135 recommendations, calling for a new ER at the LGH as well as a more decentralized approach in the hiring of staff and decision-making. Dupuis’s mandate was to pinpoint problems at the LGH that were flagged after a Montreal Gazette series documented six patient deaths in the ER amid overcrowding, a lack of staff, and other chronic problems.
The West Island CIUSSS has already taken steps to improve the situation in the existing ER ward following Dupuis’s report, said Jean-François Miron, the assistant director general at the regional heath authority.
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“This report was taken very seriously by the teams and management and there was an action plan that was put into place,” he said. “It’s being followed weekly in advancement of all recommendations that were in that report.”
The physical layout of the ER on the ground floor of the modular building will improve efficiency and safety, Miron said.
“Right now, we have more of a linear emergency, meaning one beside another,” he said. “In the new ER, it’ll be in modular systems with the posts for the nurses and doctors in the middle and all the beds around, so that should help as well.”
Medical and rapid-access clinics will be on the second floor of the modular unit, which will be staffed with family doctors that will help with the fluidity of the ER by caring for non-urgent patients, Miron said.
“It’s an important step to change on the way things are now, even though we’ve been working hard to make things a lot better than they were,” he added. “That modular system is certainly going to create a step change towards what we wish to implement as best practices for the new ER (to be built).”
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The temporary facility will have 37 ER stretchers, compared with the 31-stretcher capacity of the existing ER.
Work on the structure begins this month. It’s set to open next spring. It will be used during the construction of the new, permanent ER building and beyond for potential reconfiguration projects in the existing hospital building.
The permanent 8,300-square-metre building to be constructed at the LGH, expected to open in spring 2028, will feature 38 emergency-ward stretchers in cubicles on the ground floor, a short-term, 12-bed hospitalization unit in physical health and a six-bed, short-term intervention unit in mental health on the upper floor. It will also include examination rooms, pre-triage and triage zones, medical imaging rooms as well as a 10-seat rapid assessment zone. A mechanical equipment room will be set up in the basement.
So far, the province has allocated $14.5 million toward a business model, the design phase to produce detailed specifications and cost estimates to construct the new ER.
The LGH’s ER reputation took a sharp hit with the recent investigative reports, but at least the situation is seemingly being addressed with these projects.
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