Pour soulager rapidement les urgences du Grand Montréal qui croulent sous les patients, le gouvernement lancera dans les prochains jours deux cliniques d’infirmières praticiennes spécialisées dans la métropole. Une ligne « Un appel, un service » sera aussi activée et des « agents de fluidité » veilleront à ce que les lits d’hôpitaux se libèrent plus rapidement.
Publié à 14h10
En point de presse mardi après-midi, le ministre de la Santé, Christian Dubé, a présenté les trois premières solutions qui émanent de la cellule de crise créée la semaine dernière pour soulager les salles d’urgence du Grand Montréal.
Dans une lettre envoyée la semaine dernière à M. Dubé, le Regroupement des chefs d’urgence du Québec (RCUQ) mentionnait avoir averti dès juin les dirigeants du réseau de la gravité de la crise dans les urgences. Dans sa missive, le RCUQ reprochait à certains PDG de CISSS et de CIUSSS de ne pas avoir agi pour répartir la pression dans le réseau.
Le ministre Dubé le reconnaît : « des choses ont été recommandées depuis quelques années, mais jamais implantées ». Coordonnateur de la cellule de crise, le sous-ministre adjoint à la Direction générale de la coordination réseau et ministérielle et des affaires institutionnelles, Daniel Desharnais, aura le difficile mandat de de s’assurer que les solutions soient cette fois-ci réellement appliquées sur le terrain par les PDG. Il assure qu’il n’utilisera « pas le fouet ». Mais travaillera à la « mobilisation des équipes ». « Tout est dans l’exécution […] You can arrive with the best recommendations in the world. But the message must get through,” added Minister Dubé.
Three quick fixes
Because the emergency situation has worsened in recent months, Minister Dubé announced that three solutions will be implemented “in the very short term”. Including the creation of two specialized nurse practitioner (SNP) clinics in the east and south-central of Montreal. “We talked a lot about decompartmentalising the professions. We realized that things were already done, but not implemented […]
Why can we have an SPI clinic in Quebec, but not in Montreal? asks Mr. Dubé. The latter recognizes that this solution could have been implemented before. “We are going to stop the bureaucracy a little bit or perhaps the resistance of certain groups on this,” assures the minister.
A “One call, one service” line has also been activated since Monday and will allow several patients, particularly pediatric patients, to call to obtain a health service and avoid going to the emergency room. This line, which will go through 811, will be very similar to the popular “One call, one appointment” service that was launched during the pandemic before being put on ice.
The Assistant Deputy Minister in the General Directorate of Academic, Medical, Nursing and Pharmaceutical Affairs, Lucie Opatrny, assures that both orphan patients and those with family doctors will be able to use this service. Medical federations have agreed to increase the number of appointment slots available in pediatric clinics and FMGs to accommodate these patients.
Minister Dubé mentions that half of the 350,000 monthly emergency room visits “could have gone elsewhere”. “If we are able to better reorganize […] it’s a big effort that we can make,” he says.
Get patients out faster
To help free up hospital beds more quickly, “fluidity officers” positions are being created in each hospital. And each establishment is invited to imitate the Jewish General Hospital and to equip itself with a “command center” to manage its beds more efficiently.
The government is also accelerating the purchase of 1,700 places to accommodate patients at the end of acute care at the hospital. Quebec currently has just under 2,000 of these patients waiting in hospital for a place in a CHSLD or in rehabilitation, for example. With the purchase of these beds, the objective is that these patients wait outside the hospital for their service.
Minister Dubé believes that the crisis affecting the Lakeshore General Hospital’s emergency room is an example showing that each establishment has not implemented the solutions in the same way. La Presse revealed on Tuesday morning the existence of a mediation report evoking a real “ticking time bomb” in the Lakeshore emergency room.
“With the same problems everywhere in Quebec, some emergencies are doing better. Why do some do better than others? Sometimes there is an installation problem. Everyone knows the solutions, but some are not able to mix the ingredients,” he says. Minister Dubé hopes that the crisis unit, which will extend to all of Quebec after focusing on Greater Montreal, will bring about improvements quickly.
New strategy for wearing a mask?
Furthermore, the DD Opartny mentioned that a reflection is underway at the Ministry of Health on the possibility of reviewing the policy of wearing a mask in Quebec. Consideration is being given to adopting an approach similar to Ontario’s. “We are in the process of looking a bit like Ontario has done to see if we move towards a” syndromic “approach”, says the DD Opatrny. Quebec could thus recommend wearing a mask as soon as certain symptoms appear, not only of COVID-19, but also of other viruses, particularly respiratory ones. “Public health is looking at what the role of the mask should be now given that there is COVID, but also other respiratory viruses,” she said.