November 2017 |
From the HSC Archives (Printed in HSC Focus Newsletter)
Manitoba’s first dialysis program opened at Deer Lodge Hospital in 1958 to provide acute dialysis for patients with acute kidney failure.
Dr. Ashley Thomson, known by many as the “Father of Nephrology” in Manitoba, was the medical director of the Dialysis Program at Deer Lodge and a pioneer in the area of hemodialysis treatment and technology. In 1957-58, with the help of a technician, Dr. Thomson constructed Manitoba’s first dialysis machine with spare parts, including impellor pumps from a washing machine. In 1958, the first hemodialysis took place at Deer Lodge Hospital.
Planning for a chronic dialysis unit at Winnipeg General Hospital began in 1965 and by June 1966 construction was underway. In 1967, the Winnipeg General Hospital Dialysis Unit, a $365,000 five-bed unit occupying 3300 square feet, officially opened on G7. Dr. Thomson moved from Deer Lodge Hospital to direct the new chronic dialysis unit. He brought with him equipment, patients and two important members of his Dialysis Team staff: Pat Hill, Renal Nutritionist, and Bill Lepp, Senior Dialysis Technologist. Mrs. D. Stoski was the Head Nurse of the unit.
Up to five patients could be treated at one time in the original unit. The unit used one large central tank with a bedside monitor for each patient with each dialyzer (artificial kidney filter) prepared on site. Patients needed to go the hospital several times a week for treatments which could last eight to 10 hours. It was the most up-to-date technology for kidney disease treatment at that time. After the Dialysis Unit was established, development of a transplant program was explored by a committee of trustees, administration and medical staff. A team of doctors and nurses from Winnipeg General Hospital visited other transplant centres to observe and acquire the necessary knowledge and skills. It was expected that six to eight transplants could take place after the program was established, depending on the need of patients and kidney availability. On October 3, 1969, Winnipeg General Hospital received approval to perform kidney transplant. In November 1969 the first kidney transplant took place by a team led by surgeon Dr. Allan Downs.
HSC has been a pioneer in chronic dialysis care in Canada. It had one of only two self-care units, one of the first home hemodialysis programs and the first and largest remote satellite dialysis program in Canada.
These programs have either allowed for greater patient independence or removed the need for travel or family relocation to access chronic hemodialysis care.
The Self-Care program was originally started in 1969 by Mrs. Margaret Burrows, former assistant head nurse of the Dialysis Unit. She began the training program that was continued by Mrs. Elaine Schaffer and Miss Geri Unruh, who worked under the direction of Dr. Thomson. Teaching was done in a small room on F3. Patients who were identified as being able to manage their own treatment were taught the principles and techniques of self-dialysis.
The Home Dialysis Program followed and was established in the early 1970s to allow patients to perform dialysis independently in the comfort of their homes. In 1976, a service van for home-care dialysis equipment was donated to HSC and St. Boniface Hospital. The van operated by trained personnel, made routine service calls quarterly as well as provided repair service on home care dialysis equipment.
Patients capable of doing their own treatment who either needed some assistance or did not have the space were able to participate in their care in the Self-Care Dialysis Unit (SCDU) which officially opened on October 27, 1972 in the Kinsmen Centre on Sherbrook Street.
SCDU later moved to the corner of Sherbrook and Notre Dame with patients’ participation ranging from picking up their own supplies (known as Limited Care) to performing all aspects of the treatment. Due to the increased number of patients requiring chronic dialysis the SCDU became a full-care centre, renamed the Sherbrook Centre Dialysis Unit, and the Self-Care facility was eliminated. In 1984, the Central Dialysis Unit relocated to 6,000 square feet of newly renovated space on GA6. The unit cost $1 million and equipment costs were $400,000. With larger individual stations, it could accommodate up to 13 patients dialyzing at the same time, which doubled capacity. One of the 13 units was an isolation station and two stations were for pediatric patients or patients with acute care needs.
In 1986 the dialysis population was growing, including those unable to provide self-dialysis in areas outside of Winnipeg. HSC created the Manitoba Local Centres Dialysis Program to meet growing needs. The Local Centres have since increased to 16 sites providing chronic dialysis care for over 250 patients, including four sites directly on First Nations communities.
This was not only the first remote full-care hemodialysis program in Canada, but is the largest and most comprehensive. The program provides a unique model of care in northern and rural Manitoba partnering with the various rural RHAs and health facilities.
As the demand for dialysis services grew, the Central Dialysis Unit underwent a series of expansions from the 1990s throughout 2009 that increased capacity by adding many more stations, including those for pediatrics, and backup for the other growing components of the HSC Renal Program.
Today, the HSC Renal Program consists of full care at the General Centre (CDU-A, CDU-B and GG7), the Sherbrook Centre Dialysis Unit, Home Hemodialysis Program, and the Local Centres, providing care for close to 700 chronic hemodialysis patients, including 250 in the Manitoba Local Centres Dialysis Program. HSC also provides acute hemodialysis for approximately 250 patients per year. The HSC Renal Program provides patient training for home treatments, and for nurses providing care throughout the province.
The Renal Program at HSC Winnipeg is the result of many decades of work and dedication to research, education and most importantly, patient care. The Program is supported by an interdisciplinary team that includes nephrologists, nurses, technologists, and allied health such as social workers, dieticians, pharmacists, occupational therapists, unit assistants, unit clerks and service providers from many other programs such as spiritual care, Indigenous Health Services, Mental Health and other medical programs. The team plays a crucial role in ensuring patient care needs are met through the provision of direct renal care and through provision of consultative services for diet, medication, exercise, discharge planning and safety needs.
To celebrate the 50th anniversary of the Renal Program at HSC, the HSC Archives has created an exhibit which is mounted in the display cabinet, next to Volunteer Services, Orange Bison, Level 2.
Sources: Winnipeg General Hospital and Children’s Hospital Annual Reports and Newsletters; Renal Program Team at HSC Winnipeg
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