Nova Scotia

No single solution to patient flow challenges, says N.S. health authority

Nova Scotia Health Authority officials appeared Tuesday before the legislature's standing committee on health and said patient flow is still creating problems that extend to long waits in emergency departments and ambulance offload delays.

Issue extends to long waits in emergency departments and ambulance offload delays

Officials with the Nova Scotia Health Authority appeared before the legislature's standing committee on health Tuesday where patient flow was a major topic. (John Panella/Shutterstock)

Patient flow remains one of the biggest and most far-reaching challenges facing the province's health-care system, according to officials with the Nova Scotia Health Authority.

Officials appeared before the legislature's standing committee on health Tuesday to discuss the authority's 2017 accreditation report. While that report said most operations were in line with national standards, there were issues with patient flow.

The committee heard those challenges still exist, leading to long waits in emergency departments and ambulance offload delays.

"We're at one of those places that we need to look at what the needs of the community are and be innovative and creative in order to bridge that gap," Tim Guest, vice-president of integrated services for the health authority, told the committee.

Efficiency needed

Problems with patient flow lead back to the fact that on any given day, upward of 20 per cent of the 1,700 medical and surgical beds in the province are tied up by people who don't need acute care.

Guest said more support for home care and long-term care beds could help, but they also need to look at enhanced community support and partnerships. That could mean community clinics or partnering with other agencies to possibly combine services.

People have been hired to oversee patient flow and develop policies and processes so everyone within the system understands the issue and how it's to work.

Guest said the authority is also working with Emergency Health Services on recommendations to send the government to deal with ambulance offload delays.

"Certainly we're looking at our processes within our own organization to improve," he said.

"It's a complicated situation and it doesn't have a single solution, and it requires us to be much more efficient internally as well as look at how we can work with other providers and other organizations whose policies impact us that we have no control over."

Guest pointed to people whose hospital stays are extended while they wait for diagnostic tests as an example.

"There are opportunities that we can look at how we book those [tests]," he said.

Transportation options can also be a limiting factor for people being released from hospital, an area Guest sees potential for community collaboration.

Exit interviews

The committee also discussed efforts to make sure people leaving the system  — doctors, health authority employees and even volunteers — get to do exit interviews.

Health authority CEO Janet Knox said staff are working to develop a process that can be used throughout the province in a way that people "feel that they can say what they need to say."

"We're developing that process to be very careful about that, so not an exit interview with the person that you used to work with," she said.

Knox said exit interviews happen now, but the health authority wants a more consistent and uniform approach.

Committee to discuss ambulance delays

Meanwhile, New Democrat MLA Susan Leblanc introduced a motion calling for an emergency meeting of the committee this month to discuss ambulance offload delays and how to improve the situation.

While Liberal members of the committee would not consent to the additional meeting, they did agree to make the topic the subject of the next scheduled meeting March 12. The Grits previously blocked efforts by NDP committee members to bring the topic before the committee.

The redevelopment of health-care infrastructure in the Cape Breton Regional Municipality, which was to be discussed at the next meeting, will now go ahead at a later date.

About the Author

Michael Gorman is a reporter in Nova Scotia whose coverage areas include Province House, rural communities, and health care. Contact him with story ideas at


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