Better Health Care Sooner for Nova Scotians, Op-Ed
NOTE: The following is an op-ed piece by Dr. John Ross, provincial advisor on emergency care.
Last year, the Minister of Health asked me to recommend improvements to emergency care in this province. It wasn't a task I took lightly. Like all Nova Scotians, I value the important role each hospital has in our communities.
Over the past year, I heard from people who live the reality of emergency care every day -- doctors, nurses, mental health workers, long-term care workers, and citizens, to name a few. Their voice from the front line was crucial because they know what works and what doesn't. I wanted this report to be a reflection of those realities.
But moreover, I wanted this report to focus on the patient experience as they make their way through the emergency care system. When I focused on the report from a patients' perspective, what I saw was a broken system.
On the media front, there has been much focus on 24-7, and whether emergency departments will be open or closed overnight. I am concerned about the fear this can create for patients.
I want people to understand that my recommendations, if adopted, will give them far better access to 24-7 care than they have now. They will still have emergency departments, and much more.
For far too long, Nova Scotians have become accustomed to a level of access and quality that is less than what they deserve.
In too many communities, people call their family doctor only to be told to wait up to six weeks for an appointment. By default, they go to their local emergency department. That's not how it is supposed to work.
My report includes 26 recommendations to improve access to emergency care. The recommendations will give communities access to better care, sooner. If it's done right, long waits to see a doctor will be a thing of the past -- so will overcrowding in our larger hospitals.
In smaller hospitals, the problem is less about overcrowding and more about access to care.
When people are told to wait weeks to see their doctor, they go to their emergency department for treatment of a sore throat, a cut or an upset stomach. That is if their local emergency department is open.
Frequent emergency department closures in some communities create uncertainty. Last year, emergency rooms were closed for more than 19,000 hours provincewide. That's the equivalent of 795 days. Unpredictable closures cause stress that can be avoided.
My report recommends creating collaborative care centres where people can get better care, including emergency care, sooner. That means same or next day access to a clinician instead of waiting weeks or going to the emergency department and waiting hours to be seen.
There has been some confusion in the reporting around these centres. Some media have reported that I recommended closing emergency departments overnight. That is not correct.
Emergency departments remain a very important part of collaborative care centres. I also recommend options to keep the centres open overnight, if the district health authority, hospital staff, and community choose. These options include innovative on-call systems, including enabling staff in smaller hospitals to reach out to doctors in larger centres through video conferencing.
It really comes down to the distinct needs of each community, and about supporting them in making the right decisions on how to match services to real needs. It is also about making the best use of the time and skills of our doctors, nurses, paramedics, our HealthLink nurse line, and all who provide care as part of a more effective 24-7 emergency care system.
Collectively, the recommendations I've made will mean better health care, sooner for patients. I encourage you to read my report at www.gov.ns.ca/health and get involved in ensuring the health care in your community matches your needs.