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
    • Francophone health service discussions are taking place.
    • A federal grant proposal on anti-Indigenous racism has been submitted for engagement and cultural safety development.
    • Work is underway to expand Mi'kmaq language interpretation within the healthcare system.
    • 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
    • Funding has been allocated for the development of a Sisterhood model, and planning for the Brotherhood expansion is ongoing.
    • An evaluation is underway on the potential zone(s) for expansion of the Nova Scotia Brotherhood.
  • Continuously advance the delivery of healthcare through research and experimentation
    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 Canadian Clinical Trials Network launched with strategic priorities identified for collaborative work. Over $3.6 million in funding secured through national partnerships with a focus on workforce training and job generation.
    • 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 Canadian Institute of Health Research (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 of 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 underway. 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 will be implemented.
    • The IWK has launched a recognition platform.
    • An IWK peer support program and 90-Second Nurse pilot is underway. Schwartz Rounds are being piloted for critical incident debrief.
  • 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
    • Development of a multi-year infrastructure plan is underway. The first draft of the plan was provided to stakeholders in November 2022, with a follow up version provided in January 2023. This document will also include the infrastructure projects anticipated for implementation between April 2023 and March 2024.
    • 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.
  • 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
    • New urgent treatment centres are opening in Annapolis Royal and Baddeck. This new model of care will provide a new option for patients to get urgent healthcare treatment close to home.
    • Urgent treatment centres have been opened in Parrsboro and North Sydney.
    • Planning is underway to implement urgent care centers at Lillian Fraser Memorial Hospital, Dartmouth North, Mumford Road, 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.
    • Implementation planning is underway for interdisciplinary team expansion in hospitals that support 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 to support seniors at home to gain independence with support from three RN, Occupational Therapist, and handyperson teams.
    • 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 Health Innovation Hub.
    • 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 reduces the need for multiple nursing visits for medication administration. 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 provide seniors with information on Healthy Practices, Active Living, Healthy Relationships & Healthy Eating. An evaluation of the Seniors and Long-Term Care (SLTC) funded and NSCC-run program is underway to inform planning regarding expansion to other communities. The program services between 165 and 227 people in Middleton each week.
    • Expand patient transfer units to reduce the use of ambulances for transfers between facilities in Halifax and Cape Breton
    • EHS continues to support EMCi in hiring Transport Operators. To date, there have been 106 total 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 the 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 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