Winnipeg health authority launches review into patient's death in Grace Hospital hallway after 33-hour ER wait

Manitoba health officials are looking into the death of a patient who was waiting in a Grace Hospital emergency department hallway this weekend.

The patient died Saturday morning, the Winnipeg Regional Health Authority said, and was being cared for while waiting to be transferred to an in-patient bed in the west Winnipeg hospital.

The health authority said it is reviewing the death to determine whether it meets the criteria for a critical incident, and confirmed the patient had been waiting in the ER for 33 hours.

"Our patient safety teams are looking into the matter and an initial review of the circumstances surrounding this event is underway over the next number of days," the WRHA said in an email. The review could take "anywhere from a few days to more than a week."

Provincial legislation defines a critical incident as an "unintended event that occurs when health services results in a consequence to a patient that is serious, undesired and not the result of an underlying health condition or from a risk inherent in providing health services," the health authority said.

Anyone can report a possible patient safety event, the WRHA added. Anytime that happens, the health authority reviews the case to see if it is a critical incident.

"The purpose of critical incident reporting is to look at what can be done differently and what improvements can be made to the way health-care providers work," the health authority said.

The wait time inside Grace Hospital's ER was seven hours as of Wednesday morning, according to the health authority's website. Eleven patients were waiting for care while 48 were currently being treated.

Department 'was a zoo'

In September, the median wait time for the ER was just under five hours, according to the latest health authority data. One in 10 patients waited more than 10 hours for care that month.

Darlene Jackson, president of the Manitoba Nurses Union, said wait times are increasing in Winnipeg ERs, due to nursing shortages and workload issues. 

She said the ER department "was a zoo" this past weekend.

"They had up to 100 patients through their department that day," which is more patients than the ER normally sees, Jackson told CBC.

"It was a very, very busy, chaotic weekend."

Staff told her about Saturday's death on Monday. She said she wasn't given many details, but was told the patient was among others waiting on stretchers in hallways.

"These patients need to have eyes on them, they need to be monitored, and the workload and the patient ratios in those emergency departments are just absolutely unrealistic, and the staff are just not able to provide the care that's required."

Jackson said the Grace ER and others across the province are seeing "bottlenecking," where patients who are admitted are waiting for beds, while others from the waiting room are also waiting to be seen.

"[Staff] are now looking after in-patients that need to have full care, have their meds given, and that is not normally what ER staff do," she said.

Health Minister Uzoma Asagwara said during question period at the Manitoba legislature on Wednesday that they met with health-care leadership upon hearing the news. They said steps have been taken and are already underway in response to the incident.

Asagwara said action was taken to ensure that resources such as nurses, allied health-care professionals and health-care aides were brought in as supplementary staff to "strengthen the capacity" at the Grace Hospital.

"Beyond that one measure, which is a big step — making sure that all hands are on deck essentially, managers working extended hours, really everybody chipping in to boost staffing capacity," Asagwara told reporters following question period.  

Leadership at the Grace Hospital and the leadership of the Winnipeg Regional Authority worked collaboratively and are in ongoing communication to find supplementary staff and bring them in, Asagwara said.

The minister also said there have been internal efforts made at the hospital to try and meet the challenges, citing management putting in more hours to try and meet the demands.

Interim Liberal Leader Cindy Lamoureux said the government should be open about the staffing plan and the steps that are being taken with all MLAs. 

"I would question where are the health-care professionals coming from," she said. "We know there's a shortage all over Manitoba right now." 

Asagwara said additional steps will come in the next few days to announce the government's strategies around what supporting the Grace and other hospitals is going to look like.

The government has to explore "every option and all opportunities" to strengthen capacity in the province, Asagwara said.  

"The news that we've all heard and that I received on the weekend shortly after the incident is incredibly saddening, it's tragic," said Asagwara. "And our heart goes out to the families and the staff who are all impacted by what's happened at the Grace and by the conditions there, that are very difficult and we know that."