Lachine Hospital's ER to reopen without ICU units, sparking mixed emotions in community

The Lachine Hospital in Montreal is set to regain its 24-hour emergency services by this fall, according to the McGill University Health Centre (MUHC).

However, there will no longer be an intensive care unit, which has drawn criticism from medical staff and the borough's mayor.

The hospital's Conseil des médecins, dentistes et pharmaciens (CMDP) local committee president, Dr. Geneviève Chaput, compared the situation to a car without an engine.

"We have the emergency room, but we don't have the engine to care for patients who need to be transferred to other hospitals," she said.

Similarly, Dr. Ariane Murray, head of the Département régional de médecine générale de Montréal (DRMG), which represents 2,800 Montreal-area GPs, said, "It leaves us with a certain questioning about clinical trajectories and organization of care."

The announcement was made Wednesday after consulting with various stakeholders, including the Ministry of Health. 

"The Lachine Hospital emergency department will gradually reopen over the next few months to finally be able to receive walk-in patients and ambulances 24 hours a day, seven days a week," the MUCH said in a news release.

For several months now, the ER has only received patients who can come by their own means between 8 a.m. and 10 p.m. Ambulances called to the area are diverted to other Montreal hospitals.

ICU units nearby, MUHC says

The MUHC says, due to the hospital's location a few kilometres away from other hospitals with ICU services, it would continue to transfer patients who require a higher level of care. 

However, this decision may result in a high number of transfers, leading to more ambulance travel and increased risk for patients, said Murray. This news comes at a time when there is an effort to minimize transfers, she added.

Additionally, she said, there could be staffing difficulties with the reopening of the emergency room and the planned addition of 20 hospital beds to the existing 36 beds over the next 12 to 18 months.

She said more beds could lead to more patients experiencing complications and becoming unstable without an ICU, which would further burden other hospitals.

Despite these concerns, the MUHC says it considers the hospital's revitalization plan to be an opportunity to modernize the facility. Roughly $220 million has been earmarked for that effort.

On Tuesday, a delegation of elected officials and citizens went to the National Assembly to demand that Minister Christian Dubé intervene and ensure a fully functional hospital is reopen to serve the community.

During question period on Tuesday, Dubé said he trusts the managers in the field to find a solution and respect the essential role of the Lachine Hospital.

Mayor worries plan lacks ICU

Lachine borough mayor Maja Vodanovic has described the hospital as a model of the minister's vision, which speaks of more humane, more efficient care that is closer to people.

Yet after the announcement Wednesday, she told CBC News she had been expecting great news, "but now I am not sure."

She said the proposal is "not a full win" at a time when hospitals are running over capacity and there is a struggle to find enough staff.

She appreciates that the MUHC is recognizing the importance of the hospital in the community, and that there will be somebody in charge with a team, she said.

"But the fact that there are no intensive care units anymore is a bit questionable." she said. "If you don't have intensive care units, it's not a full hospital."

Chantal Richer, a licensed practical nurse at the Lachine Hospital, said the announcement has been greeted with mixed emotions. 

On one hand, the staff is happy, but on the other, she said, without intensive care the hospital is missing a crucial component in patient care. She was among those who went to Quebec City to demand the health minister intervene.

She said someone may come in with a heart attack, get stabilized and then need to be transferred rather than staying close to their community, where friends and family live. She said the closest hospitals with ICUs are not easily accessible by public transit.

"We're a big family in Lachine. We work together," Richer said. "We have a big heart in Lachine. So this is affecting us a lot."