Emergency department closure report shows problems persist at most troubled N.S. locations
Despite some progress, recruitment challenges and closures continue at some sites
A new report on emergency department closures in Nova Scotia suggests some progress is happening, but a closer look reveals that the province's biggest problem sites are getting worse.
As required by legislation, the provincial government posted the annual closure report online late last month. Unlike previous years, it was not proactively announced and Health Minister Michelle Thompson was not available for an interview.
While the report shows an overall decrease in closures for 2023-24 compared to the previous year, there are several distinctions. This year's report, for example, does not include data on scheduled closure hours at each site, a departure from previous reports.
The report also notes that some sites that formerly operated as emergency departments, such as All Saints Hospital in Springhill and Musquodoboit Valley Memorial Hospital in Middle Musquodoboit, no longer do so and therefore are not included in the report.
Other sites that have previously been converted to urgent treatment centres, which provide same-day and next-day appointments for people with non-life-threatening conditions, are also left out of the most recent report, meaning the closure hours that they accounted for in past reports are not factored into the most recent document because it only considers emergency departments.
The document points to efforts to recruit and retain more doctors and other health-care professionals as one thing that's helped reduce the time some emergency departments are closed.
People have also been assigned roles to ensure that patients spend less time waiting in emergency departments before being admitted and that in-patient beds are turned over more quickly when they become available.
The government has also taken steps to make sure people without family doctors can get basic care without having to attend an emergency department through expanded access to virtual care, mobile primary care clinics that travel around the province, and primary care clinics in pharmacies.
Persistent problem sites continue to struggle
Even with these steps, however, the rural and community emergency departments that have been plagued with closures for years are seeing numbers tick up again in the most recent report.
Fishermen's Memorial Hospital in Lunenburg was closed for 2,155.5 unscheduled hours in 2023-24, up from 1,255.5 the previous year. Roseway Hospital in Shelburne experienced 4,832 unscheduled closure hours in the most recent report compared to 2,904 in 2022-23. At Digby General Hospital, meanwhile, closure hours in 2023-24 hit 3,923.8, up from the previous report's 2,779.5.
The report also outlines how long patients wait to be seen by a provider in an emergency department after being triaged.
The situation has improved at the IWK Health Centre in Halifax, where patients in 2023-24 waited on average one hour and 45 minutes compared to two hours in 2022-23.
Wait times to be seen
The average wait time at Nova Scotia Health emergency departments was 2.96 hours, a slight increase from the average of 2.8 hours in the previous report.
The average wait is much longer at some hospitals, however, including:
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Cape Breton Regional Hospital: 5.73 hours.
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Digby General Hospital: 4.58 hours.
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Fishermen's Memorial: 6.05 hours.
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Roseway Hospital: 13.68 hours.
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South Shore Regional: 4.91 hours.
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Yarmouth Regional: 6.16 hours.
Tanya Penney, Nova Scotia Health's senior director of the emergency program of care and executive director for the central zone, said wait times can be influenced by a variety of factors. Those include whether there is more than one doctor working in an emergency department, the ability to move patients out of emergency departments and into other areas of care, and the severity of cases that staff are treating.
Penney said efforts to improve the movement of patients by expanding the things nurses are allowed to do in more minor cases has helped improve things in certain areas.
"It really does depend on what the root cause [is] and it does vary site by site."
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