Emergency departments experience 15 per cent increase in closure hours

    Pictured is the emergency department at Strait-Richmond Hospital in Evanston which had 828 temporary closure hours in 2017-18.

    STRAIT AREA: Two emergency departments in the Strait area, less than 50-kilometres apart, were closed a total of 1,279-hours during 2017-18, according to the recent release of the annual Accountability Report on Emergency Departments, published by the Department of Health and Wellness.

    While the number of emergency department closure hours is on the rise throughout the province, closures at certain facilities have become increasingly commonplace in the Eastern Zone, according to the report which confirms a 15 per cent increase in closure hours throughout the zone over the previous year.

    According to the report, which was released last month, province-wide there were a total of 17,926 scheduled closure hours and 12,567.5 temporary closure hours, compared with last years’ numbers of 19,707 scheduled hours of closure, along with 5,417.5 temporary closures.

    In Zone 3 (Eastern Zone), there was a total of 13,979 emergency department closure hours, including 9,741 scheduled closures and 4,238 temporary closure hours.

    “Emergency department closures that are unpredictable and unplanned are considered temporary closures,” Health and Wellness Minister Randy Delorey said of the report. “We continue to work with the Nova Scotia Health Authority [NSHA] to reduce temporary emergency department closures. In 2017–18, 18 hospitals experienced temporary closures as a result of emergency department staff [nurses, physicians or paramedics] unavailability.”

    Emergency departments with no scheduled closure hours saw, the Strait Richmond Hospital in Evanston with 828 temporary closure hours, St. Anne Community and Nursing Care Centre in Arichat had 451 temporary closure hours and the Guysborough Memorial Hospital had seven temporary closure hours.

    PC Health and Wellness critic Karla MacFarlane said that the data contained in the report is shocking. Since Stephen McNeil became Premier, she said there is a 96 per cent increase in closure hours, and in the last year alone, that increased by an astonishing 20 per cent across the province.

    “It’s obvious the McNeil Liberals are ducking accountability on emergency department closures in Nova Scotia,” she said. “How can the McNeil Liberals say there’s no crisis in healthcare when emergency department closures have doubled since they took office?”

    Tanya Penney, NSHA senior director of critical care and emergency programs of care, said her sense from talking to folks all across the province is it’s a significant commitment for our family physicians to staff emergency departments.

    “Fortunately many of them do work in the emergency department but they do that in addition to their already busy office practices; so obviously they can’t be in two places at once,” she told The Reporter in phone interview last week. “On the flip side of that, not all of our family doctors choose to work in the emergency department, or feel comfortable working in an area of emergency medicine.”

    Penney said there are issues aligning doctors who have other competing priorities and then there are doctors who don’t feel comfortable to work the emergency department.

    Brett MacDougall, NSHA executive director operations for the Eastern Zone, said it’s unfortunate but temporary closures do occur.

    “As we work through a number of resourcing issues, we look at physicians from other areas, locums, and we get to a point where we feel that we need to give public notice and unfortunately we need to do a temporary closure,” he said on the temporary closures being a last resort. “We recognize here in Cape Breton and the Eastern Zone there is a need for physicians, recruitment doesn’t happen overnight, it sometimes takes time, sometimes over a year.”

    MacDougall spoke on the NSHA’s successful recruitment of a new infection practitioner after losing an infection specialist a little over two years ago and hopes they’ll be able to attract more physicians to the Eastern Zone.

    Addressing any misconceptions about temporary emergency department closures, Penney said it’s not something the NSHA takes lightly.

    “We do have a process to follow and it’s a very rigorous process,” she said. “It’s certainly not done in a blink of an eye.”

    Nova Scotia’s 38 emergency departments is the most per capita of any other province in the country, and Penney highlights the NSHA isn’t in a unique situation as other provinces such as Alberta, Saskatchewan and Northern Ontario all face issues in rural areas.

    “Any increase in closures are concerning, a driver of those closures is a small amount of facilities, that NSHA through physician recruitment, working with primary care, working with the emergency program of care, those are places we’re putting some dedicated recruitment into,” she said. “There are specific areas of the province that require higher needs of attention and that is one of them.”

    MacDougall explained in the case of a temporary closure to call 911 for an emergency and also suggested the 811 service, a tele-medicine service which is very helpful and what he says is a under-utilized service.

    “We’re trying to respond where possible, back to a common cure sometimes [and] we end up with a temporary closure,” he said. “It’s certainly not what we’re striving for, we’re trying to make sure the public has the ability to go seek emergency services where necessary.”

    Both Penney and MacDougall agreed at the end of the day, they would rather see an emergency department enter temporary closure hours rather than being in a position of not being able to offer services to a patient in need.

    “These numbers represent real hardship for Nova Scotians who expect access to emergency healthcare close to home,” MacFarlane concluded. “This report is a stark reminder of just how badly the Liberal government is failing Nova Scotians.”