Health Transformation Hub

Improving emergency care in Nova Scotia is a priority. There are many initiatives, both immediate and long-term, to improve emergency care for patients and healthcare staff. These initiatives will ensure all Nova Scotians receive timely urgent and emergent care when needed.

Established in 2023, the emergency care improvement plan is designed to support paramedics, doctors, nurses, and emergency department (ED) staff to provide the best care possible for patients by:

• Ensuring people with the most urgent needs receive care faster.
• Improving ambulance response times through a collaborative partnership with Emergency Health Services (EHS).
• Establishing more options for people to receive the care they need, which will reduce pressure on EDs and improve resource allocation.

Our goal is to reduce pressure on EDs by helping Nova Scotians understand the many opportunities they have to receive care in other settings. The aim is to create a network of emergency healthcare that provides timely access to consistent care for patients and families.  

Current activities under this initiative include:

• Supporting urgent treatment centres to provide appointments for urgent issues sooner.
• Increasing access to emergency care to ensure that people with the most emergent care needs get seen faster by:
  • Improving ambulance flow through an ambulance response strategy in partnership with Emergency Health Services (EHS).
  • Ensuring that Waiting Room Care Providers and Patient Advocates are present in waiting rooms throughout the province.
  • Improving patient flow through EDs by integrating flexible care spaces.
  • Expanding Virtual Urgent Nova Scotia (VUNS) to provide more healthcare options for Nova Scotians.
  • Maintaining and increasing the number of Physician Assistants and Nurse Practitioners providing care in EDs.

We are providing quicker access to ED care by: 

• Improving processes and resource utilization within EDs to ensure patients with the most urgent needs receive care faster and are seen in a timely manner.
• Establishing care areas called Rapid Assessment Zones (RAZ) to optimize use of staffing and space. RAZs care for patients who can remain in chairs or recliners while receiving care.
• Making virtual emergency care and virtual urgent care available to more patients. 

Since the initiative was established, the following milestones have been reached:

• Waiting Room Care Providers and Patient Advocates are in place at all regional sites to support safety, care and comfort in the waiting room.
• Seven regional sites have incorporated a Physician Flow Lead role into their teams to optimize patient flow within the EDs and support earlier initiation of diagnostics and treatment.
• Eleven Nurse Practitioners have been integrated into EDs across the province.
• Seven Physician Assistants have been added to ED care teams to support physicians to see more patients.
• Ambulance offload time improvement as part of the System Accountability Framework implementation at Nova Scotia Health.
• Launched a process modeling project to assess flow and processes within every ED in Nova Scotia in collaboration with physicians, staff, and leadership. The results will guide recommendations for evidence-based interventions to improve workflows and models of care, ensuring patients receive timely care from the appropriate provider in the right space.
• Rapid Assessment Zone (RAZ) implementation initiated at 5 sites with the goal of reducing wait times, improving patient flow, and safely reducing length of stay for discharged patients.
• Split-flow model implemented at Cobequid Community Health Centre and the IWK to reduce wait times, improve patient flow, and care outcomes.
• Virtual Urgent NS implemented at 18 sites with two more planned before fall 2024.
• Trauma Consult Service improvements have improved Intensive Care Unit (ICU) overall length of stay, and improved patient and provider satisfaction.
• Launched a website that displays anticipated waiting durations at ten EDs throughout the province. This resource provides individuals with an estimate of the expected wait times for receiving medical care.

If you have any questions about this initiative, please contact EIACnetwork@nshealth.ca

Leads

• Kate Melvin, Senior Director, Episodic and Integrated Acute Care Network, Nova Scotia Health
• Dr. Paige Moorhouse, Senior Medical Director, Episodic and Integrated Acute Care Network, Nova Scotia Health
• Tanya Penney, Senior Executive Director, Emergency Care Priorities, Nova Scotia Department of Health and Wellness

Executive Sponsors

• Dr. Nicole Boutilier, Executive Vice President of Medicine and Clinical Operations, Nova Scotia Health
• Colin Stevenson, Chief, System Integration, Nova Scotia Department of Health and Wellness