Solution Four: Build in accountability at every level

Our transformed health system will be coordinated and equitable, with a shared understanding of expectations, roles, responsibilities, and success driving high performance. Transparency and openness will help Nova Scotians understand what’s happening and why decisions are being made.

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

  • Clearly articulate desired culture and expectations, and model behaviours that drive excellence at every level
    Actions will includeProgress UpdateStatus
    • Establish a leadership development program with greater attention given to underrepresented groups, including Indigenous and African Nova Scotians
    • A Health Equity Partnership Group has been established between health system partners.
    • IWK is developing a 3-tiered approach to leadership development with a special focus on employees from equity-deserving groups who are interested in formal leadership positions. The work is in progress, looking for areas that can be aligned with the provincial Leadership Development Program.
    • The Department of Health and Wellness will soon start work on a system wide leadership development program for underrepresented groups.
    • Review and refresh long-term care funding and agreements
    • A review of long-term care agreements is on track to be completed by March 31, 2024.
    • Explore funding models that provide more choice for both individuals and caregivers, providing them with more opportunities to arrange their own services, while ensuring accountability for investments made
    • A review of home care direct funding programs is complete. Work is underway to finalize next steps on a new consolidated and streamlined direct funding program.
    • Introduce a healthcare auditor as a new officer of the legislature to guide and support a culture of continuous improvement
    • Work is underway with the Auditor General to establish a healthcare auditor role.
  • Reduce red tape and duplication to direct more resources to quality patient care
    Actions will includeProgress UpdateStatus
    • Review and modify the organizational structure of healthcare to reduce duplication and ensure it’s designed around patient needs and behaviours
    • A Health Leadership Team has been established to provide strategic leadership, decision-making, and oversight to the health system.
    • Improve governance in the continuing care system to reduce administration and confusion, and improve accountability
    • Contracts will be renewed and strengthened to ensure clear governance, accountability, and expectations in all aspects of the programs. Monitoring and compliance practices will be applied with funding initiatives to ensure intended outcomes are achieved with investments.
    • Planning is underway to provide training and support to delivery agencies in 2023-2024 to improve governance, reduce administration, and improve collaboration, innovation, and accountability.
    • Develop modern and flexible legislation and regulatory regime that supports a person-centred approach to service delivery in continuing care
    • Minimum direct care staffing for Registered Nurses, Licensed Practical Nurses, and Continuing Care Assistants will be established across the sector to ensure a standard level of care across the province in long-term care facilities and improve quality of care for residents.
    • Review the current approach to case management to ensure a person-centred approach that maximizes flexibility for client in continuing care and their families
    • A review of home care direct funding is complete. Work is underway to finalize next steps on a new consolidated and streamlined direct funding program to offer maximum flexibility.
    • Review existing workflows for opportunities to reduce the amount of time spent on paperwork
    • Policy streamlining and standardization is in progress.
    • An online physician credentialling system has been implemented at IWK, replacing legacy paper processes.
    • Interprovincial Practice and Learning introduced Dynamic Health to give a virtual decision-making tool to clinicians with to enhance access to best evidence and reduce red tape.
    • Implement digital solutions to improve processes
    • A Care Coordination Centre is being launched to facilitate access to real time data and decision-making.
    • Digital initiatives, including real-time emergency room patient tracking and self-service registration kiosks, are being implemented.
    • A future state strategy is being designed and implemented.
    • IWK has established a Digital Transformation committee of the Board and confirmed Digital Transformation as a strategic priority for 2023-2024.
    • Continue to identify opportunities to reduce unnecessary administrative burden on physicians, staff, and patients
    • Initiatives to reduce physician administrative tasks have been identified and are being implemented:
      • The IWK moved its credential application process from being paper-based to a complete online system.
      • Several high-frequency forms are being reviewed, with physician input, for improvement.
  • Set clear and transparent metrics and standards for the planning and delivery of health services and publicly report on results
    Actions will includeProgress UpdateStatus
    • Develop an Integrated Health Services Planning Framework that outlines program standards and standards for the delivery of health services
    • Health system partners have established standards and guidance for local zone health services planning. Operational planning for each zone is proceeding with local leadership.
    • The IWK is working with zones for services focused on children, youth, women and families.
    • Develop health system indicators to measure and report publicly on progress and performance of the health system
    • The initial series of public indicators to track improvements in health system performance has been published. This first set of indicators has been updated quarterly, and continues to be added to as more data becomes available.
    • Maintain performance agreements with the health authorities
    • The Health Authorities, the Department of Health and Wellness, and the Department of Seniors and Long-Term Care have finalized 3-year performance agreements for 2022-2023 to 2024-2025.
  • Improve public and provider access to information to ensure accessibility, a coordinated and equitable approach, and clear expectations
    Actions will includeProgress UpdateStatus
    • Use data to drive decisions and determine where improvement is needed
    • A shared reporting environment has been developed between health system partners.
    • Work with diverse communities to ensure access to culturally specific information
    • Work is underway, including initiatives to support equitable vaccine access for all People of African Descent in Nova Scotia, and to further support Indigenous Health consultants and expansion of Mi'kmaq language interpretation.
  • Improve coordination and collaboration across the health system to address and avoid gaps in service
    Actions will includeProgress UpdateStatus
    • Continue to integrate continuing-care programs with other areas of the health system to improve transitions and continuity of care
    • A Health System Partner Working Group has been created with acute and long-term care sector representatives. Focus has been placed on improving the efficiency of information transfer when clients transition between care settings.
    • Establish new ways of working with Tajikeimɨk to support Mi’kmaw-led health priorities and improved health outcomes for Mi’kmaq and other Indigenous groups
    • A Memorandum of Understanding between Tajikeimɨk, federal, and provincial governments was signed in April 2023 outlining a commitment to health transformation and priority actions.
    • Tajikeimɨk and the Department of Health and Wellness co-lead the Tajikeimɨk Strategic Health Partnership Committee to create opportunities for collaboration and coordination between Tajikeimɨk, the province, and other partners to inform and influence provincial health planning, decision- making, policy, legislation and regulations, service delivery, and funding processes affecting the Mi’kmaq people of Nova Scotia.
    • Establish a health equity partnership including Department of Health and Wellness, NS Health, IWK, and other stakeholders to understand and address equity issues in the system
    • A Health Equity Partnership has been established between health system partners to address equity issues in the system, including health staff and patient experience.
    • Establish a Patient Navigation Program to support Indigenous patients, and equity-seeking and racialized patients, navigating the health system
    • Eight Indigenous patient navigators were funded under the 2023-2024 budget; six for NS Health and two for the IWK.
    • The Department of Health and Wellness will continue to work with health partners to develop a plan for implementing an Indigenous Navigation Program into the health system.
    • Improve the integration of mental health and addictions services across the health system, including primary healthcare and emergency departments
    • Health Authorities have implemented roles providing early intervention, engagement, wellness support, and system navigation. These roles work with youth community organizations to connect children, youth, and families to early primary health and mental health support.
    • A Crisis and Urgent Care team has been formed, including a virtual support team, supporting patients and emergency department staff.
    • IWK’s Learning Link includes a physical and virtual space for clients, families, clinicians, and community partners to work together. The Learning Link serves as a hub of expertise for Nova Scotian and Maritime MHA clinicians and community partners to enhance knowledge and deliver evidence-based clinical care.
    • IWK led the implementation of Trauma Informed Care across all child and adolescent MHA services and emergency departments across the province.
    • NS Health created the Provincial Centre for Training, Education, and Learning.
    • Champion a three-digit mental health crisis phone line
    • Consultation with the Canadian Radio-television and Telecommunications Commission (CRTC) has occurred.
    • Nova Scotia is actively participating in federal/provincial/territorial working group meetings to gather priorities on the implementation of 9-8-8 in Canada.
    • Conduct a full review of the formulary of drugs covered by Pharmacare programs to ensure the needs of Nova Scotians are met
    • Review has been completed of NS Formulary compared to other jurisdictions, and changes have been made to align where possible. A review of past CADTH recommendations has also been completed.
    • Products have been moved to full benefit status to improve access.
    • Ongoing maintenance of the formulary continues, including continuing efforts to streamline ESD processes through red tape reduction work and addressing workload and staffing as part of the division’s usual work.

Solution Four Results

We said we would clearly articulate desired culture and expectation, and model behaviours that drive excellence at every level.

To track our progress, we will monitor feedback from patients on the quality of their stay in hospital.

The Canadian Patient Experience Survey asks hospital patients in Nova Scotia to rate the hospital they stayed in. We are reporting what percentage of patients provide a score of at least 8-out-of-10 for Nova Scotia Health and the IWK.
77.2 %
Nova Scotia Health
91.1 %
Solution Three Solution Five