ER Advisor Recommends Improvements to Emergency Health Care
October 26, 2010
Nova Scotians should get better health care sooner, says the physician in charge of reviewing the province’s emergency health-care system.
Dr. John Ross, a 20-year veteran of emergency medicine, presented his report on emergency care, today, Oct. 26, to Health Minister Maureen MacDonald. Dr. Ross said people who now wait weeks to see their family doctor should get same- or next-day access to health care. Those who need emergency care should wait less, too.
“Every hospital and clinic in this province has a role in providing the right care for people when it’s needed most,” said Dr. Ross. “In all the communities and hospitals that I visited, the resounding concern was uncertainty. People are afraid of losing existing health services. My report outlines recommendations that will improve access to care and improve the kind of care that patients get throughout the province.”
Dr. Ross’s report includes 26 recommendations to:
— create same- or next-day access to primary care by creating collaborative health care teams
— explore more innovative ways to pay physicians
— make hospital funding models outcome and performance-based
— enhance the role and scope of work for all health care professionals
— adopt and implement emergency care standards
— enhance the roles of paramedics and HealthLink 811
— change the way hospitals provide services to seniors
— enhance access to mental health services
Dr. Ross said the biggest problem for smaller hospital emergency rooms is that people go there by default for non-urgent care because they cannot see their family doctor.
“Almost 90 per cent of visits to smaller emergency departments are for medical problems that could be adequately treated in a clinic setting, and most of these visits occur during the day and evening,” he said. “In the overnight, we pay doctors to be available but many times, they see only one patient. There are some nights when they see no one.
“Taxpayers spend hundreds of thousands of dollars per hospital site each year for this kind of coverage. This isn’t good use of scarce health dollars nor of the skills of doctors and nurses.”
Dr. Ross recommends creating a collaborative assessment room for emergencies in 16 community hospitals. The centres will allow access to a health-care provider sooner — often with same- or next-day appointments. The clinics would reduce visits to the emergency department and limit the uncertainty caused by frequent, unplanned emergency department closures.
In larger hospitals, overcrowding causes long waits for patients. The report suggests creating fast-track areas for X-rays and common tests, staggering shift changes, improving communication with waiting patients, and reviewing and changing the scope of work to support the skills of nurses and doctors.
The report also recommends minimum care standards to improve the quality and consistency of emergency care in all regions. Dr. Ross said Nova Scotia could be the first province in Canada to adopt and meet such standards.
He also recommends enhancing the role of paramedics, increasing senior-focused services to better meet their needs, improving mobile emergency mental-health services, and broadening the scope of services provided through HealthLink 811.
Government will review the report and respond to Dr. Ross’s recommendations shortly.
“I want to thank Dr. Ross for his work,” said Ms. MacDonald. “I look forward to sharing the report with my colleagues, responding to the recommendations, and working to provide better health care to all Nova Scotians across the province.”
Dr. Ross was appointed by government last year to develop a report to improve emergency care. A copy of the report is available at www.gov.ns.ca/health/emergencycarereport