Healthcare reform takes a step forward in Nova Scotia with the homes model approach
Nova Scotia's Primary Care Transformation: A Steady Progress
Nova Scotia's healthcare system is undergoing a significant transformation, with a focus on improving access to primary care services. This evolution is marked by the integration of technology, expanded roles for nurse practitioners, and strategic physician recruitment.
Dr. Colin Newman, president of Nova Scotia's College of Family Physicians, advocates for education as a key solution to increase the number of family doctors. He proposes a pathway that includes increasing medical school enrollment, creating positive learning environments in family medicine, and providing high-quality community-based family medicine training to graduates.
One of the most notable innovations is the Care Coordination Centre (C3), launched province-wide to streamline patient transitions between care settings, manage hospital bed availability, and expedite appointment scheduling. This initiative has reduced wait times and smoothed care delivery, thereby enhancing patient access to timely care.
Nurse Practitioners (NPs) like Alison MacMellon are leading new team-based service delivery models, focusing on transitional health care and supporting patients discharged from hospitals who need continuing care before returning home. NPs serve as the Most Responsible Practitioners, coordinating comprehensive care and improving outcomes within community-based and transitional settings.
Nova Scotia Health has actively recruited physicians, both hospitalists trained in and outside Canada, to bolster primary and inpatient care teams. This has strengthened capacity to deliver timely, patient-centered care, ensuring patients receive coordinated and focused management throughout hospital stays.
While direct statistics on waitlist reduction are not detailed, the implementation of C3 and nurse-practitioner-led care teams indicates progress by enhancing patient flow and increasing care capacity. As a result, the waitlist for a family doctor has decreased by approximately 70,779 people since July 2021.
Last year, the number of family medicine school seats in Nova Scotia was increased from 58 to 114. Nova Scotia Health interim president and CEO Karen Oldfield acknowledges that progress is being made in this transition, with 118 health homes currently operating across the province.
Primary health care in Nova Scotia is now delivered by teams that include family physicians, nurse practitioners, nurses, social workers, dietitians, pharmacists, physiotherapists, and many others. The province added 253 new doctors last year, resulting in a net gain of 187 doctors, almost double the number of physicians added the year before.
Despite these advancements, 89,455 people, or 8.3% of the population, are still on the waitlist for a family doctor in Nova Scotia. Dr. Oldfield attributes the decrease in the family doctor waitlist to a range of strategies, including recruitment and retention, new technology, and effort from people across the province.
The Progressive Conservative government, which was elected in August 2021, largely campaigned on a promise to fix health care in Nova Scotia. The number of Nova Scotians who have been connected to primary health care has increased under the current administration, according to Dr. Oldfield. The shift in Nova Scotia's health care system is a testament to the government's commitment to addressing healthcare concerns and improving access to primary care services for its residents.
References:
- Nova Scotia Health Authority (2022). Care Coordination Centre (C3). Retrieved from http://www.nshealth.ca/care-coordination-centre-c3
- Nova Scotia Health Authority (2022). Nurse Practitioner-Led Clinics. Retrieved from http://www.nshealth.ca/nurse-practitioner-led-clinics
- Nova Scotia Health Authority (2022). Physician Recruitment and Retention. Retrieved from http://www.nshealth.ca/physician-recruitment-and-retention
- Canadian Institute for Health Information (2021). Wait Times in Canada: A Report Card. Retrieved from https://www.cihi.ca/en/wait-times-in-canada-a-report-card
- The integration of technology in Nova Scotia's healthcare system is a vital part of the ongoing transformation, aiming to improve access to primary care services.
- The Care Coordination Centre (C3), a new technology-driven initiative, streamlines patient transitions between care settings and expedites appointment scheduling for smoother care delivery.
- Video conferences and telemedicine technologies have become valuable tools for medical-conditions consultations, especially for patients with chronic diseases such as COPD and type-2 diabetes.
- In deciding the best treatment paths for cancer patients, advancements in science and technology play a crucial role in therapies and treatments.
- The environment plays a significant role in health and wellness; technology can help monitor and manage various aspects of eye-health, hearing, and digestive health.
- The healthcare workforce integrates specialists like social workers, dietitians, pharmacists, and physiotherapists, working together to improve chronic kidney disease, respiratory conditions, skin conditions, and overall cardiovascular health.
- Sleep patterns may indicate the presence of underlying health issues; technological devices can track and analyze data related to sleep patterns and alert medical professionals, thus contributing to early detection and treatment of potential medical conditions.
- Education is a key component of increasing access to primary care services, particularly by expanding medical school enrollment and creating positive learning environments in family medicine.
- Autoimmune disorders, such as psoriasis and rheumatoid arthritis, require specialized attention from medical professionals; primary care teams are better equipped to manage patients with such conditions due to the diversified healthcare workforce.
- Fitness and exercise, as part of a balanced lifestyle, can help prevent and manage a range of chronic diseases, from diabetes to heart diseases; healthcare professionals encourage patients to prioritize their nutrition and mental health.
- A focus on health and wellness includes mental health considerations; therapies and treatments for mental health issues are an integral part of the transformation in Nova Scotia's healthcare system.
- Nurse practitioners, like Alison MacMellon, are instrumental in providing continuous care for patients discharged from hospitals, ensuring a smooth transition to home through team-based service delivery.
- The healthcare transformation in Nova Scotia is not just about reducing waitlists for family doctors but also about increasing care capacity to manage and care for patients more effectively, whether it's through technology, expanded roles for nurse practitioners, or strategic physician recruitment.
