Province releases accountability report
AMHERST – While emergency room closures still occur, the province’s fourth Emergency Department Accountability Report indicates they are fewer and farther apart in Cumberland County.
The report issued earlier this week indicates that ERs are staying open because of the creation of collaborative emergency centres, three of which are located in the county.
Compared to four years ago, the number of hours of closures has gone down 21 per cent – when Health and Wellness began collecting the data.
In the seven communities that have collaborative emergency centres, including Parrsboro, Springhill and Pugwash, that decline is even more dramatic – a 92 per cent drop in the number of hours the emergency department is closed.
"Our emergency care system is better across Nova Scotia, thanks to the nurses, paramedics, doctors and those work in collaborative emergency centres and who've provided good care and helped change the system in order to keep emergency rooms open," Health and Wellness Minister David Wilson said in a news release. "CECs are a great new way to deliver better care sooner, a model that is being copies across Canada. We know that there are still some places where more improvements can be made, and we are listening to communities that tell us government can do even better."
In Cumberland County, where ER closures were commonplace in the three smaller hospitals, the number of closures sharply declined.
In Parrsboro, the hospital’s ER closed for only 66 hours between July 27, 2011 and July 26, 2013; compared to 426 hours between July 27, 2010 and July 26, 2011 – the day before the CEC opened.
The difference is more dramatic at All Saints Hospital. There were only 47 hours of closure there between March 28, 2012 and March 27, 2013; compared to 1,212 between March 28, 2011 and March 27, 2012.
In Pugwash, there were 1,204 hours the ER was closed between Sept. 19, 2011 and Sept. 18, 2012. Between Sept. 19, 2012 and July 31, 2013 there were 80 hours when the CEC was on reduced services.
This is good news for the Cumberland Health Authority, that took a lead role in creating the collaborative practice model with doctors and nurses working with nurse practitioners and paramedics with physician oversight.
“There has been a significant reduction in the number of closures. There is but a handful now and it’s usually the rare occasion when there’s a last-minute sick call from a paramedic or a physician is unavailable and we cannot find someone to replace him in time,” health authority CEO Bruce Quigley said.
Because physicians no longer have responsibility to provide 24-hour coverage in the emergency departments, Quigley said, they are more available in their offices.”
Quigley said working as a team with nurse practitioners, there are more appointments available during daytime hours and patients can see a primary care provider rather than having no option than to go to the ER.
Since Nova Scotia introduced the CEC concept, governments in Saskatchewan and Prince Edward Island have said they want to bring in the model. Officials from both provinces visited the CECs in Springhill and Parrsboro.
"In many communities, Nova Scotians were waiting weeks to see a doctor and small rural emergency rooms were frequently closed," said Wilson. "CECs have made a huge difference, creating reliable access to health-care services and better care overall."
The annual accountability report is required under the province's Emergency Department Closures Accountability Act. The act states district health authorities are to consult with their communities about closures, during public forums and to consider solutions, proposed by the community, to keep emergency departments open.
"CECs are community-based and locally managed solutions to the basic health care needs of Nova Scotians, while maintaining ready access to 24 hour emergency care," said Dr. John Ross, the province's emergency care advisor. "The innovative core teams of paramedics, nurses, and physicians, with support from many others, make best use of available resources."
According to the Accountability Report on Emergency Departments, in 2012-13, emergency departments in hospitals across the province were open 95.4 per cent of the time, overall. Twenty-five of the province's 38 hospitals, including the Cumberland Regional Health Care Centre, had no closures over that year.
Thirteen hospitals did experience closures, for a total of 15,083 hours.
The report can be found at http://novascotia.ca/DHW/ .