Solution Three: Cultivate excellence on the frontlines

Our plan will build and empower connected care teams as respected entrepreneurs and innovators who have the information, technology, and tools they need to provide a high standard of care.

Our progress on what we will do

  • Ongoing Status Icon

    Work Ongoing: Started and continues through 2022-26

  • Complete Status Icon

    Complete: The action is complete

  • Work Underway Status Icon

    Work Underway: The action has been initiated

  • Not Started Status Icon

    Not Started: The action has not been initiated yet

  • Invest in health equipment, technology, and infrastructure to support a safe, attractive, and healthy workplace
    Actions will includeProgress UpdateStatus
    • Develop modern infrastructure to support the health system, including the continued implementation of the QEII New Generation and Cape Breton Regional Municipality Redevelopment projects
    • Bayers Lake Community Outpatient Centre construction remains on schedule for final completion in February 2024. The procurement remains in progress, although a new and faster plan was announced on December 15, 2022. This plan will see an increase in the number of operating rooms, patient beds, and a new emergency department on the Halifax Infirmary site. It also includes planning work to expand infrastructure supports at the Dartmouth General Hospital and Cobequid sites, the creation of two Transition-to-Community Facilities in HRM, as well as the entire previous scope (Cancer Care, Heart Health).
    • A new Addictions and Mental Health Campus concept, planning for the NS Rehabilitation and Arthritis centre, and the development for a replacement of the MacKenzie Lab were also announced on December 15, 2022.
    • Work has started on the IWK Health Centre’s new emergency department, which will more than double its current size.
    • 17 Federally funded (ICIP) infrastructure projects are underway at the IWK and are scheduled to be completed by March 2023.
    • A cardiac catheterization lab will be included in the new clinical services building as part of the Cape Breton Regional Municipality Health Care Redevelopment project. It will improve patient outcomes, reduce wait times for cardiac services, and free up hospital beds in Cape Breton and across the province.
    • An Energy Centre, helipad, and cancer centre are currently under construction on the CB Regional Development site.
    • Dartmouth General Hospital: doubled the ORs from 4 to 8, added 54 beds, and an additional 6 dialysis stations. Construction started in May 2017 and is completed. ORs and additional beds are being activated for patient care.
    • Halifax Infirmary 3rd and 5th floor renovations included a new Hybrid OR, DI interventional suites, mechanical penthouse, relocation of admin offices, patient/family waiting and consult rooms, PACU isolation rooms, and upgrades to satellite MDR. Construction is now complete and is activated for patient care.
    • Halifax Infirmary Emergency Department administration and support area is now operationalized, adding 14,386 sq. ft expansion on top of the existing emergency department to relocate admin offices.
    • Replace and expand medical equipment to support safe, quality care, including upgrades to laboratory services, diagnostic imaging, and cardiac care
    • A hybrid operating room, the first in Atlantic Canada, is now in use at the Halifax Infirmary site of the QEII Health Sciences Centre. It includes advanced diagnostic imaging equipment that allows patients having cardiac or vascular surgery to undergo diagnostic tests in the room if complications arise, which is safer for patients. With other operating rooms, a patient would have to be moved to where the diagnostic equipment is located. The QEII Foundation raised $4 million to support the purchase of equipment.
    • Annual funding for equipment and repairs has been increased to $67 million.
    • A six-station dialysis unit is temporarily being established at Cumberland Regional Health Care Centre in Amherst.
    • A pilot project to improve renal dialysis access was launched in Chéticamp.
    • Design for manufacture model for dialysis infrastructure was approved for investigation.
    • North Cumberland Health Centre redevelopment remains on schedule for spring 2023.
    • Implement IT solutions to improve patient care, access, and flow across the system, such as a transportation scheduling system and a bed placement system in long-term care
    • A pilot project is underway to explore community transport as a patient transport alternative. Software options to assist with scheduling are being evaluated.
    • A new long-term care e-placement solution, PathWays, has been successfully launched. This will support the placement process for people moving to long-term care.
    • Expand the 'command centre' model to Central Zone and eventually province-wide
    • The Care Coordination Centre (C3) is now fully operational at the QEII Health Sciences Centre. Technical implementation of the Capacity Expeditor, Boarders Expeditor, and Patient Manager Tiles are complete. The Transfers Expeditor will go live in February. Emergency Expeditor will go live by April. Overall, the project is ahead of schedule.
    • Clinical implementation (e.g., training, workflow improvement, standardization of operating procedures) is ongoing.
    • In December, C3 accelerated the implementation (saving 11 months of schedule) and successfully added all Central Zone sites to Capacity Expeditor; and Dartmouth General to Patient Manager.
    • This advanced technology will build upon new and existing processes, clinical pathways, operational routines, and accountabilities, and the new technology, processes, and team will help improve access and flow of patients through the system and improve the quality of patient care delivered.
  • Increase professional development and practice supports
    Actions will includeProgress UpdateStatus
    • Develop a mentorship program to support early-career nurses entering the workforce
    • A transition-to-practice program provides new graduates with a residency program including access to simulation training, mentorship, e-modules, and simulation learning modules.
    • A new Nurse Mentorship Program pilot has been implemented, and is already being scaled up to all medicine and inpatient units.
    • Implement the Work and Learn Continuing Care Assistant Education Model
    • Over 500 students have started in the Continuing Care Assistant Work and Learn program, allowing students to work two days per week and study three days per week.
    • Nova Scotia expects to increase capacity for Work and Learn seats due to high interest this year.
    • Ensure health providers have access to addictions and mental health training and education
    • IWK Learning Link now provides capacity-building opportunities for health providers. Access will be made available for NS Health and community partners.
    • NS Health continues to provide access to consultation support to health care providers, including primary care, through Addictions Medicine and the Provincial Centre for Training, Education, and Learning.
    • NS Health provides access to educational opportunities through the Nova Scotia Learning Institute for Health Care Providers. Staff can learn from non-traditional stakeholders, interprofessional key partners, external stakeholders, and internal departments to develop and deliver education programming. This program was originally known as Registered Nurses Professional Development Centre.
    • Enhance access to development opportunities for underrepresented healthcare providers
    • The province is collaborating with NS Health and Doctors NS on professional development initiatives for underrepresented healthcare providers and an action learning project.
    • IWK is developing a mentorship program and future leaders’ development program for employees from underrepresented groups.
  • Increase the number of care teams working together to maximize resources and provide safe, quality care
    Actions will includeProgress UpdateStatus
    • Leverage information and technology to connect care teams and enhance collaboration
    • NS Health’s Innovation Hub has launched a six-month pilot program with Virtual Hallway, a Nova Scotian company that connects primary care providers with specialists to improve patient access to specialist care.
    • Electronic Medical Record (EMR) improvements are being explored.
  • Continue efforts to standardize and simplify how health providers work
    Actions will includeProgress UpdateStatus
    • Implement best practices to reduce variation in surgical procedures to improve patient care
    • Best practice activities are ongoing, including development of evidence-based toolkits and improved patient education pamphlets.
    • In collaboration with the Online Learning Group at Queen's University, a Shared Decision Making (SDM) module has been developed and is ready for asynchronous education of health care providers. After completion the health care providers will know the steps to support SDM and have practiced their ability to hear patients’ concerns, assure comprehension, and facilitate expression of treatment preferences.
  • Address barriers and optimize the ability of health providers to work to their full scope of practice
    Actions will includeProgress UpdateStatus
    • Review and assess restrictions limiting health providers from working to their optimal scope of practice
    • Examples of work completed and underway include:
      • Legislative changes to allow Nurse Practitioners to admit patients to hospital
      • RN prescribing has been implemented
      • Pharmacy Collaborative Clinic
      • Paramedic role optimization
      • Review of the role of Pharmacy Technicians
    • Work is underway with Dalhousie Family Medicine Clinics to optimize roles and scopes within current practice, such as Family Practice Nurses.
    • The Office of Addictions and Mental Health is working to create a comprehensive Mental Health and Addictions Health Human Resources strategy to support a Universal Mental Health and Addictions Care Framework. Work underway includes understanding current supply of Occupational Therapists, Registered Nurses (and Nurse Practitioners), Registered Counselling Therapists, and Registered Social Workers to optimize their roles and scope of practice within mental health and addictions care.
    • Explore opportunities to expand the role of health providers, such as nurses, pharmacists, and paramedics, to support delivery of health services
    • Innovative staffing models are being implemented with rapid training programs to support required competencies for pharmacists, advanced care paramedics, and emergency support aides.
    • The fall intake for the Critical Care Paramedic program at NS Health’s Learning Institute has been increased, and enrollment doubled.
    • Expand the registered nurse prescribing pilot to improve access to approved services and medications
    • Health system partners are working with Dalhousie to expand the training program with an intake goal of 30 for September 2022 and 30 for January 2023.
  • Ensure diversity, inclusion, and representation at all levels of the health system, including leadership, to generate a workforce that represents the people being served
    Actions will includeProgress UpdateStatus
    • Develop measurable diversity, equity, and inclusion frameworks and assign accountability at all levels of the health system
    • Equity, diversity, and inclusion metrics are being developed by the province.
    • A review of NS Health’s equity framework is underway.
    • A Health Equity Metrics and Data Indicators Working Group is developing indicators to measure EDI in the healthcare system.
    • Review health policies, programs, and services to understand equity gaps and develop solutions
    • Health system partner discussions are occurring through the health equity partnership table.
    • Create designated African Nova Scotian health consultant positions to provide leadership and guidance in the delivery of culturally specific health services
    • Health system partners are discussing strategies for supporting delivery of culturally specific health services to the African Nova Scotian Community.
    • Department of Health and Wellness has hired an African Nova Scotian Health Equity Advisor to work with African Nova Scotian Health Consultants at NS Health.
    • Department of Health and Wellness is working with the IWK to secure an African Nova Scotian health consultant for the IWK system.
  • Focus on keeping current healthcare workers through retention efforts and supports aimed at rebuilding the resilience of the health workforce
    Actions will includeProgress UpdateStatus
    • Continue to engage health providers and support staff, including those who have moved within and outside of the province, on factors that influence retention
    • Plans for stakeholder engagement and recruitment and retention are being developed.
    • Develop or enhance existing policies, strategies, and initiatives through a lens of retention, including onboarding of new hires and matching physicians to opportunities in communities that fit their lifestyle
    • Paramedic Temporary License & Shift Ending Policy has been implemented, meaning paramedics are guaranteed to be released at the end of their shifts. Development of a nurse mentorship program is underway.
    • IWK and NS Health are working to expand their existing nursing mentorship program.
    • Level the playing field with respect to remuneration and pay family doctors at a rate that is in line with that of hospitalists
    • Project planning and data gathering are underway.

Solution Three Results

We said we would invest in health equipment, technology, and infrastructure to support a safe, attractive, and healthy workplace.

We will monitor employee satisfaction scores from Nova Scotia Health and the IWK, which will provide an indicator of how well these changes are helping improve the employee experience.

The Worklife Pulse Survey asks employees: “Overall, how would you rate your organization as a place to work?” We are reporting the percentage of employees who provide a score of at least 8-out-of-10 for Nova Scotia Health and the IWK.
67.4 %
42.4 %
Nova Scotia Health

We said we would focus on retaining our current healthcare workers.

We will monitor how many of the current workforce of Registered Nurses have stayed employed at NS Health and IWK for at least five years in a row. This will provide a clear picture of employment stability among this priority health profession.
86.9 %
Baseline 2021-2022
90 %
We will also monitor how well the health system is able to fill necessary positions through the vacancy rate at NS Health and IWK.

Vacancy Rate

Solution Two Solution Four