The Nova Scotia government has unveiled a slate of actions they say will improve emergency care, after the stories of two women who died following seven-hour-long waits in ERs shook the province.
The health department says it will begin assigning physician assistants and nurse practitioners to provide care in emergency departments.
It will also have teams led by doctors focusing on getting patients out of ambulances and into ERs faster, as well as add care providers and patient advocates in waiting rooms.
According to a release, the province will also make virtual care available to more patients with less urgent needs, and will provide health teams with real-time data on available beds across the system. Real-time data will also let healthcare teams see what tests are needed to get patients home quicker.
This announcement comes after a day-long summit of N.S. officials and health-care partners, which included representatives from regulatory colleges, professional associations, education institutions, unions and service providers. It was held after days of intense scrutiny following the recent deaths of two women in emergency rooms.
Allison Holthoff, 37, died after a seven-hour wait at the Cumberland Regional Health Centre emergency department in Amherst, N.S., on Dec. 31, 2022. Just a day prior, 67-year-old Charlene Snow waited for seven hours at the Cape Breton Regional Hospital emergency department before giving up and going home, where she died shortly after.
In a statement released Thursday, Holthoff’s husband, Gunter, said the plan was “too little and it’s too late.”
“Most of the changes announced had already been in the planning stages for months or years and will not have a real impact on our health system for the same amount of time. What’s missing is a sense of urgency,” he said.
Following the Tuesday summit, Premier Tim Houston said he’s “open to anything” to improve the province’s struggling health-care system. He said the summit had been in the works for a while, but news of the two deaths gave it a new sense of urgency.
In the announcement release on Wednesday, Health Minister Michelle Thompson said the provincial government has been making “record-high investments” in health-care, echoing the recent events added a sense of urgency.
“Everyone working in emergency care do all they can, day in and day out, to provide the best possible care for their patients,” Thompson wrote.
“This plan should help them help their patients get the care they need more quickly.”
Support for paramedics, reducing pressure on ERs
A part of the slate of actions was also a plan to support paramedics, including providing training at more Nova Scotia Community College (NSCC) campuses.
The province also promises a tuition rebate of $11,500 to paramedics who agree to work in Nova Scotia for at least three years.
Also, a second air ambulance will be added to handle routine transfers between Sydney and Halifax, and Yarmouth and Halifax, “allowing ground ambulances to stay in communities more often.”
Funding will be given to train medical first responders, as they are sometimes the first to arrive to emergency scenes.
Nova Scotia also plans on offering more places for residents to receive care and relieve some of the pressure on emergency departments, it said.
The province wants to expand services in more pharmacies, and province more mobile primary care, as well as mobile respiratory care clinics and urgent treatment centres.
Another part of the plan is enabling out-of-province doctors who are licensed in Nova Scotia to offer virtual care. The province will also add more hours for virtual care appointments overall.
President and CEO of Nova Scotia Health, Karen Oldfield, said in the release the province’s health-care system was built “during a different era” and has not changed much.
“That is not our future. No one person can move this mountain by themselves,” Oldfield said. “We can do it if we all pull together with a common goal: a system that is ready, responsive and reliable.”
As for whether the plan will work on a practical level, is being questioned by some.
Cheryl Burbridge, a licensed practical nurse at Valley Regional Hospital in Kentville has been working on the front lines of health care for four decades.
She says since COVID-19, pressures on emergency departments have been intense but notes that hospitals are already doing everything they can to help patients, including many of the actions the province put forward on Wednesday.
“We have had a waiting room nurse for several years. We had in the last couple of years what we call a transition team,” she said.
The challenge, she says, is resources. She says their designated waiting room nurse often gets pulled out of the waiting room to help with treatments.
“Sometimes there’s just not enough boots on the ground to do everything that needs to be done,” she said.
That’s where the opposition says the province’s new action plan falls short.
“One critical question that’s not being answered is where are the new workers coming from,” said Liberal Leader Zach Churchill.
“We have a vacancy rate up to 80 per cent in some of our hospitals. They’re making new positions to address the crisis in our ERs. Where are these people coming from?”
Meanwhile, NDP Leader Claudia Chender says government has not offered details on cost and timing.
“We didn’t hear nearly enough about retention .Not only do we have a massive recruitment issue that we need … but we are losing healthcare workers,” she added.
Alexandra Rose, the coordinator for the Nova Scotia Health Coalition, adds that government is too focused on the short term.
Instead, Rose believes they should be prioritizing things like mental health, food security and affordable housing.
“All of that contributes to our health., Until we see investments into our social determinants of health, I don’t think we’ll see long-term are solutions,” said Rose.
— With files from Alex Cooke and Alicia Draus