Montreal General to close 23-bed stroke and brain-injury unit
MUHC says it must comply with a ‘legal requirement’ to slash $7M
Despite making $21 million in cuts to its budget, the McGill University Health Centre must still comply with a “legal requirement” to chop another $7 million, and has decided to close a unit at the Montreal General Hospital for stroke and traumatic brain-injury patients, the Montreal Gazette has learned.
The closing this summer of the 23-bed unit will result in 14 to 15 stroke patients being transferred to the Montreal Neurological Hospital, and eight to nine traumatic brain-injury (TBI) patients being absorbed by the surgical ward at the Montreal General.
But there are concerns among MUHC officials that during the summer trauma season, the surgical ward could swell to more than nine TBI patients on some days, and consequently other surgeries might have to be postponed.
The MUHC will also reduce the number of sitters it hires to monitor certain patients, notably those at risk of wandering or falling because of confusion and others who may interfere with their treatment by pulling on their equipment.
Pierre Hurteau, co-president of the Central Users Committee of the MUHC, said he’s concerned about the potential impact of the latest budget cuts on patient care.
Hurteau noted that the Montreal General is a Level I trauma centre, and he can’t understand why the MUHC has decided to close the stroke and TBI unit.
“Why did we create a unit dedicated to (TBI) patients in the first place?” Hurteau asked. “Now it’s no longer a good idea because we have to cut (spending) somewhere?”
The MUHC released a statement Friday defending its decision to close the unit: “On the whole, this project makes a great deal of clinical sense. The net number of beds will remain unchanged. The patients will simply be integrated and managed under the resources already available in the locations they are moving to.”
Martine Alfonso, interim executive director of the MUHC, alluded to the closing of the unit in a memo sent to staff on Wednesday, outlining 12 “optimization projects” to save $7 million. Alfonso described in positive terms the transfer of stroke patients to the Neuro, saying that “units will be renovated and enlarged to improve the care for patients and the work environment for the clinical team.”
Alfonso emphasized that “the goal to return to a balanced budget is not only an MUHC priority at this time but it is also a legal requirement. In achieving this goal, we have kept access to our healthcare services and the safety of our patients at the forefront of all decision-making.”
The MUHC also has a legal obligation to provide care to an increasing number of patients, but is struggling to do so amid budget cuts that are steeper than other institutions in Quebec.
The MUHC’s budget today stands at $850 million, down from more than $1 billion a few years ago. What’s more, Health Minister Gaétan Barrette has decided to fund the MUHC at a bed-occupancy rate of 85 per cent. It’s usually at 90 to 95 per cent, and the MUHC has argued it needs 100 per cent as a buffer.
The MUHC, which also runs the superhospital at the Glen site, has reduced the number of staffed beds and has cancelled more than 1,000 elective surgeries as part of the first round of $21 million in cuts.
In its statement Friday, the MUHC also defended the decision to reduce the number of sitters: “Using a sitter is not always the best solution. There is actually little evidence to suggest that sitters are better at preventing patients from wandering, falling and pulling out their endotracheal tubes than other solutions, such as tracking bracelets.”
Why did we create a unit dedicated to (TBI) patients in the first place? Now it’s no longer a good idea because we have to cut (spending) somewhere?