Houston, health care partners talk emergency department crisis at summit

A news conference will be held Wednesday morning where Health Minister Michelle Thompson and Nova Scotia Health president and CEO Karen Oldfield are expected to announce “improvements” to care provided at emergency departments.  

The briefing follows a rare meeting on Tuesday between Premier Tim Houston, Thompson, top civil servants, and “health care partners,” which included organizations representing doctors, nurses, pharmacists, licensing bodies, and universities.  

The Halifax Examiner also noted the presence of Dr. John Ross, a former chief of emergency medicine at the QEII Health Sciences Centre who, back in January 2009, called a “Code Orange” or mass casualty alert because the hospital didn’t have the beds to admit a backlog of 18 patients. Ross went on to advocate for changes in the health care system. He was appointed by the Dexter government as an advisor on emergency health before moving to work with a private company offering health care to workers in remote locations. 

Although the health care “summit” had been organized two weeks ago, the high-profile deaths of 37-year-old Allison Holthoff at the Cumberland Regional Emergency Dec. 31, and 67-year-old Charlene Snow, who died after leaving Cape Breton Regional Emergency on Dec. 30, have intensified the pressure on the Houston government to make changes. 

Expanding scope of practice

Cumberland North Independent MLA Elizabeth Smith-McCrossin presented the government with a seven-point plan that includes increasing nursing staff at Cumberland Regional Health Care Centre and replacing the makeshift emergency department after a flood last May.  

A vice-president with the Nova Scotia Government Employees Union representing nurses at the Halifax Infirmary wrote a letter Jan. 9 urging the government to stop “the revolving door” by offering bonuses to retain experienced nurses and extra pay to those forced to work short-handed caring for more patients.  

Although the problems are well known, reporters left Tuesaday’s briefing uncertain what action will be announced today. Both Houston and Doctors Nova Scotia president Nancy MacCready-Williams hinted that a key to improving the situation at overcrowded emergency departments is to “expand the scope of practice” among various health care professions so patients can be seen and treated without having to spend seven hours in an emergency room. 

“There’s lots of work for all healthcare practitioners in this province and the coordination of that so it’s seamless for patients — physicians working in partnership and on collaborative care teams with nurses and pharmacists and other professionals, that is the future. It’s the answer,” said MacCready-Williams. “It’s best practice primary care. And we aren’t doing it well, so it is going to take some coordination to sort out how we do this better. But what I heard today was a resounding ‘yes,’ Let’s see where we can go quickly. This isn’t about studies and reports; it’s about trying things and getting it right.”  

A consensus seems to be building that the silos separating what a paramedic or a doctor or a nurse practitioner can do must come down to preserve access to emergency care for patients who need it the most. The collaborative care model talked about for more than a dozen years may finally be about to get its day. 

Mostly the briefing contained a large dose of cheerleading. Houston opened the briefing telling reporters his message to the large group of health care partners and civil servants was to “go like hell” and do what it takes to make improvements.   

Not much talk of compensation

Money wasn’t talked about much, although Houston acknowledged compensation is part of the staffing issue, he says that will be addressed during contract negotiations. By then it may be too late, according to Hugh Gillis, the NSGEU vice-president who says nurses at the Halifax Infirmary emergency department are continuing to leave for jobs where they can make more money and choose how often they want to work. 

“They are working side by side with travel nurses and the travel nurses are getting paid a great deal more money, in some cases double. So, what does that do for morale?” asked Gillis. 

Travel nurses work for privately-owned nursing agencies. The government has hired them to fill some of the 1500 vacant nursing positions in order to prevent hospital beds from closing. Many have arrived from other provinces.  

On the political front, a request from NDP leader Claudia Chender to call Nova Scotia Health CEO Karen Oldfield and Health Minister Michelle Thompson as witnesses at Thursday’s scheduled meeting of the Legislature’s Health Committee was rejected. Such a request must have unanimous consent. Public Health will be the topic.  

Late yesterday, Cumberland North MLA Elizabeth Smith-McCrossin filed a similar request asking that Karen Oldfield and deputy health minister Jeannine Lagassé be called as witnesses to answer questions about the circumstances at the Cumberland emergency department on Dec. 31. That request requires another vote. 

 Here’s a list of organizations that attended the Health Summit: 

— Cape Breton University 
— Dalhousie University Faculty of Medicine 
— Doctors Nova Scotia 
— Emergency Medical Care Inc. 
— IWK Health 
— Medavie Blue Cross 
— Nova Scotia College of Family Physicians 
— Nova Scotia College of Nursing 
— Nova Scotia College of Pharmacists 
— Nova Scotia College of Physicians and Surgeons 
— Nova Scotia Community College 
— Nova Scotia Government and General Employees Union 
— Nova Scotia Health 
— Nova Scotia Nurses’ Union 
— Pharmacy Association of Nova Scotia 
— physician advisors 
— St. Francis Xavier University – Rankin School of Nursing