Solution Five: Be responsive and resilient

We will invest in public health, research, preparedness, and emergency response to build a system that can weather ups and downs and will position us for a healthy future. More decisions will be made locally and will be focused on keeping Nova Scotians healthy.

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

  • Engage with, learn from, and collaborate with communities and support organizations to improve access to culturally appropriate services
    Actions will includeProgress UpdateStatus
    • Work with communities, including First Nations, Acadian, and Francophone communities, to ensure their language interpretation needs are met
    • Funding has been given to Reseau Sante to expand their French language program and training to health professionals.
    • Francophone health service discussions continue to take place with system partners and community organizations.
    • A federal grant proposal on anti-Indigenous racism has been submitted for engagement and cultural safety development.
    • Under the 2023-24 budget, funding has been approved to expand Mi'kmaq language interpretation within the healthcare system.
    • One of the largest public healthcare tours in the province’s history was completed in 2023, with more than 1,000 Nova Scotians engaged in community healthcare conversations.
    • Improve access to services in African Nova Scotian communities through the expansion of the Nova Scotia Brotherhood Initiative and the development of a Sisterhood model
    • The Nova Scotia Sisterhood program has been launched and operating, providing health services to African Nova Scotian women.
    • Funding for the Brotherhood expansion has been approved in the 2023-2024 budget.
  • Continuously advance the delivery of healthcare through research and learning by doing
    Actions will includeProgress UpdateStatus
    • Encourage research and discovery through the Health Innovation Hub
    • Multiple initiatives are in progress. The Health Innovation Hub is working with partners from the health system, the province, industry, residents in innovation, clinician scientists, industry and academic partners, and a network of scholars.
    • The Atlantic Clinical Trials Network (ACTN) will receive approximately $2.5 million for the training of current and future clinical trialists in the region through the CIHR (Canadian Institutes of Health Research) funded Canadian Consortium of Clinical Trial Training (CANTRAIN). It will also include the creation of various student training opportunities at the masters, PhD, postdoctoral and postdoctoral fellow levels.
    • Multiple strategic initiatives are underway to enhance research capacity and leadership nationally and internationally.
    • IWK investigators are part of a team that has received a $6.7 million CIHR grant to establish a national infrastructure for pediatric research.
    • IWK, in partnership with Cisco, has implemented innovative new technology to facilitate families who are at home to be a part of the delivery care by connecting them to health care practitioners in the NICU.
    • The Ethos Therapy system, a first-in-Canada radiation cancer treatment technology, has been installed at the Queen Elizabeth II Health Sciences Centre in Halifax.
  • Support the health and well-being of health providers
    Actions will includeProgress UpdateStatus
    • Ensure conflict resolution policies and programs are in place for health workers
    • Policy review is complete. Engagement with long-term care facilities is occurring to understand current policies.
    • Focus on workplace safety initiatives to support staff in delivery of quality care, including access to training and equipment in long-term care and the installation of power stretchers and loaders in all ambulances
    • A $3 million investment has been made in Workplace Safety Initiatives, including the implementation of a Home Care Lift Loan Program, Employee and Family Assistance Program, Stay-At-Work/Return-to-Work Program, and Safety Training Initiatives in continuing care.
    • Funding has been approved for the remainder of stretchers and power loaders to be purchased and a plan has been developed for installation of the equipment in all vehicles.
    • Work with Emergency Medical Care Inc. on workplace initiatives such as a paramedics’ mentorship program and an employee engagement committee
    • An employee engagement committee is in place and meeting regularly.
    • Planning for a formal mentorship program is underway.
    • Develop a Wellness Strategy for healthcare professionals
    • A Wellness Strategy for Healthcare Professionals has been implemented. A partnership to support coaching training for nurses will commence Fall 2023.
    • The IWK has launched a new recognition platform.
    • An IWK peer support program and 90-Second Nurse pilot is underway. Schwartz Rounds are being piloted for critical incident debrief.
    • NS Health innovation grant application process will launch in Spring 2023, with a focus on wellness initiatives.
    • The Learning Institute HCP and AIR Resilience Institute will test a program on team resilience and the correlation between healthy, high performing teams and person-centred outcomes (provider, patient, team lens). Two pilot locations are being identified.
  • Ensure projects already in progress will meet the needs of a growing and changing population
    Actions will includeProgress UpdateStatus
    • Put a plan in place to guide sustainable investments in health infrastructure over the medium and long-term
    • The Nova Scotia Healthcare System Infrastructure and Capital Investment Strategy (ICIS) has been developed. The first draft of the strategy was provided to stakeholders in November 2022 with a follow up version provided in January 2023. The accompanying Annual Plan for 2023-24 outlines areas of focus, recently completed projects, and all projects approved for planning, design or construction as well as the list of approved projects for the Capital Grants Funding Envelopes for this year.
    • Invest in community-based health services for newcomers, including child and youth services
    • Increased access to primary care services is available for newcomers through an additional $684,000 annual investment for the Newcomer Health Clinic.
    • Work has started on the IWK Health Centre’s new emergency department, which will more than double its current size.
    • Work is underway to implement an IWK supported Integrated Youth Services (IYS) model that offers low-barrier access to community-based services for youth aged 13 to 25 and their caregivers. IYS provides early intervention and prevention, as well as care to young people experiencing challenges with their mental health or substance use.
    • IWK Health was provided with 154K to enhance supports to newcomers and have expanded their clinic availability at the Newcomer Clinic with this money in addition to social work support, discharge and continuing care coordination and interpretation services.
  • Explore and implement innovative solutions to optimize resources and capacity while ensuring quality and safety
    Actions will includeProgress UpdateStatus
    • Open more urgent treatment centres to improve access to same day/next day care across the province
    • Urgent Treatment Centres have been opened in Tatamagouche, Annapolis Royal, Baddeck, Parrsboro and North Sydney. A temporary Urgent Treatment Centre is in place in Sheet Harbour.
    • Implementation is underway to implement urgent care centers in Dartmouth North, Mumford Road, Clayton Park, Bedford / Sackville, Yarmouth, Kentville and Bridgewater.
    • Review the composition of care teams to ensure appropriate resources are available to support staff and patient flow in hospital
    • Initiatives underway include authorizing qualified Registered Nurses to prescribe, and ensuring all clinicians are supported to work to their full scope.
    • Recruitment is underway for interdisciplinary team and support staff expansion in hospitals that supports patient flow through evenings and weekends.
    • Nurse Practitioners and Physician Assistants are being recruited to work in emergency departments.
    • Explore alternative levels of care to complement existing programs
    • Twelve home care demonstration projects will be implemented by March 31, 2024 to better support caregivers, trial new models of home care service delivery, and increase access to resources and equipment.
    • The Cluster Care home care pilot funds approved agencies to provide all home care services in an assigned public housing building using alternate funding and staffing models to support clients to stay in their homes and live well.
    • The Community Aging in Place—Advancing Better Living for Elders (CAPABLE) program has been approved, which partners a nurse, occupational therapist and handyperson to support seniors at home to gain independence.
    • The collaborative hotel initiative for people experiencing homelessness (the Bridge Project) will establish a new integrated model for delivering supports in a clinic environment.
    • Partner with community organizations to pilot smart home technologies and scale up solutions based on evidence
    • Opportunities to respond to clients’ needs, including through the use of technology, are being identified.
    • At-home care solutions are being explored through the Department of Seniors and Long-term Care and the Health Innovation Hub to identify promising technologies.
    • A VON pilot has expanded to provide 677 more digital medication dispensers to home nursing clients who are at risk of under- or over-medicating due to memory issues. This will bring the total number of medication dispensers in the pilot to 937.
    • Explore community hub models to support seniors’ timely access to focused care in home or long-term care settings
    • Centre of Rural Aging and Health (CORAH) uses a community hub model to provides seniors with information on Healthy Practices, Active Living, Healthy Relationships & Healthy Eating. The location of two new hub sites will be announced in August 2023.
    • Expand patient transfer units to reduce the use of ambulances for transfers between facilities in Halifax and Cape Breton
    • EHS continues to support EMCi hiring Transport Operators. To date there have been 138 total Clinical Transfer Operators hired, and additional capacity on transfer units has been created.
    • As a result, dependence on paramedics to attend low to no acuity patient transfer movements has been limited, creating increased capacity for urgent and emergency assignments.
    • In September 2021, paramedics completed 86% of patient transfer movements. These changes reduced that rate to 20% in September 2022.
    • Expand EHS Integrated Health Programs, such as the Extended Care Paramedic Program for continuing care patients, and the Community-based Paramedic Program in Cape Breton, to avoid unnecessary trips to the emergency department
    • Impacts of other system changes to relieve pressure on the emergency system and create capacity for these programs are being monitored.
    • Work is underway to develop more care options in community for low-acuity patients to avoid unnecessary trips to the hospital, including expanding the Single Paramedic Early Response (SPEAR) program to improve wait times and provide patients the right care in the right place.

Solution Five Results

We said we would use innovative solutions to optimize resources and capacity.

We will monitor and report whether the wait list for surgeries is growing, compared to how quickly people are being removed from the list. This is called the surgical waitlist growth rate ratio.

Surgical waitlist growth rate ratio

We will also monitor how long it takes for ambulances to both respond to emergencies, and to offload patients at hospitals.
These two indicators will help us track the timeliness of emergency care, and access to immediate treatment in hospitals. The chart below tracks how frequently ambulances respond to emergencies within the target time, and how often patients are offloaded at hospitals in under thirty minutes.

Percentage of ambulance response times below target

Percentage of ambulance offload intervals in less than 30 minutes

Solution Four Solution Six