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Emergency Care Plan

Improving Emergency Care


The emergency care improvement plan, developed in January 2023, is designed to move more quickly in:

  • ensuring those with the most urgent needs receive care faster
  • improving ambulance response times
  • providing more places for people to receive care.

The plan is also intended to support the dedicated and committed paramedics, doctors, nurses and other emergency department staff who are doing all that they can, day in and day out, to provide the best care possible for their patients.

Flow Lead and Offload Assessment Teams (FLOAT):

  • Doctors will lead teams within the ED focused on triaging patients and getting patients out of ambulances and into the ER faster.
  • Patients get care and ambulances get back on the road more quickly.

Waiting Room Care Providers, Patient Advocates:

  • We have reinforced and expanded our waiting room care providers. They will reassess patients as patients’ needs change.
  •  A patient advocate will be in EDs to check on and talk to patients, bring them blankets and food, and make them more comfortable. A volunteer can play this role or the waiting room care provider, depending on how busy the ED is.

Virtual Emergency Care:

  • Patients with less urgent needs can see a doctor virtually, with a paramedic or nurse on-site, at more hospitals.
  • Three hospitals have tried this, caring for almost 1,300 patients and reducing wait times to an average of 63 minutes.

Physician Assistants, Nurse Practitioners in Emergency Departments:

  • Physician assistants, under a doctor’s supervision, can care for up to 62% of all patients in emergency departments based on their skills and scope.
  • Nurse practitioners diagnose, order and interpret tests, prescribe, perform procedures and can admit, transfer and discharge patients.

Care Coordination Centre (C3) and Bed Expeditor:

  • Healthcare teams get information in real time on what tests and other steps are needed for patients to get home more quickly. Teams can make faster, more informed decisions based on bed availability, the status of diagnostic tests, the movement of patients between care areas, ambulance offloads and staff scheduling.
  • The Canadian Association of Emergency Physicians has identified the need for integrated and coordinated bed management that C3 supports.
  • Nova Scotia is the first in the country to have a province wide health command centre.

Community Fund:

  • Communities are getting funding to support their efforts to attract healthcare professionals, beginning in Cumberland County and Cape Breton.

Training More Paramedics, Giving Tuition Rebates in Return for Service:

  • More community college campuses will offer paramedic training. Training sites include Yarmouth, Pictou, and Halifax
  • Paramedics who agree to work in Nova Scotia for at least three years will receive $11,500 back from their $19,500 tuition.

2nd Air Ambulance:

  • Patients from Yarmouth and Sydney can travel by air ambulance to Halifax for routine tests and treatment.
  • Ambulances will save significant time on routine transfers and be available in their communities more.
  • It will also save significant time for patients (1 hour plane ride vs 5-hour ambulance ride) and be more comfortable for them.

Medical First Responders:

  • The government will fund training for medical first responders, typically firefighters, who are in communities and may be the first to arrive on the scene.

Collaborative Practices Seeing More Patients:

  • The Dalhousie family medical clinics, in partnership with government and Nova Scotia Health, will expand to more communities. The Dal clinics have already taken on 3,500 more patients.
  • Rapid patient onboarding teams will save health providers time (about 90 minutes per patient) and paperwork that they can spend instead on patient care.
  • New collaborative care teams are forming in 14 communities, and 37 more are getting funding to help them see more patients.
  • Graduating residents and providers are getting help to set up practices.

More Services in Pharmacies:

  • More pharmacists will have dedicated clinic hours to assess and treat minor joint and muscle pain, eczema, cold sores, urinary tract infections and shingles; provide care for chronic diseases like diabetes; renew prescriptions; and provide contraception.
  • The government is working with the Pharmacy Association of Nova Scotia and NSH/Lawtons on expanding pharmacy services in more communities and building on the PharmacyPlus success. innovationhub.nshealth.ca/projects/pharmacist-walk-in-clinic

Virtual Care Nova Scotia Expansion:

  • Patients can now schedule appointments for evenings and weekends.
  • Doctors from outside Nova Scotia can now provide virtual care.
  • Virtual care patients report a 4.6 out of 5 satisfaction rate.

Urgent Treatment Centres:

  • Patients get appointments more quickly for unexpected, non-life-threatening health issues.
  • The latest centre opened at Lillian Fraser Memorial Hospital in Tatamagouche January 2023.

Mobile Primary Care Clinics:

  • Pop-up clinics are now happening every weekend.
  • Patients and the healthcare providers report 4.9 out of 5 satisfaction rates. 

Mobile Respiratory Clinics:

  • Respiratory patients are now receiving care, including evening and weekends, in Sydney and Antigonish. The clinics will soon be available in more communities at existing COVID testing sites.

YourHealthNS:

  • Patients can find the right services for their needs and where they are offered on the YourHealthNS app on their phone as well as website www.yourhealthns.ca.

Access to Primary Healthcare and Reducing Pressures in Emergency Departments

 

Efforts to increase access to primary healthcare means more people are receiving the care they need without going to an emergency department.

  • Primary Healthcare Visits (April-November 2023)

    • 1.17 million (+18% more visits since last year)

  • Virtual Urgent Care (November-December 2023)

    • 55% of people would have gone to an emergency department

    • 36% of people would have gone to walk-in clinic

  • Virtual Care Primary Care (May 2021-December 2023)

    • 24% of people would have gone to an emergency department

    • 36% of people would have gone to a walk-in clinic

  • Mobile Primary Care (September 2022-December 2023)

    • 6% of people would have gone to an emergency department

    • 13% of people would have gone to a walk-in clinic

    • 11% of people would have gone untreated

  • Pharmacy Walk-in Clinic + (February 2021-December 2023)

    • 60% of people would have gone to and emergency department

  • YourHealthNS App (November-December 2023)

    • 15% of people would have gone to an emergency department

    • 30% of people would have looked for information online

*Sample sizes of survey responses vary for each access initiative.