ROSEWAY HOSPITAL
Emergency Department
Public Consultation Meeting
Wednesday, April 14th, 2010
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ROSEWAY HOSPITAL
Emergency Department Public Consultation
Public Consultation Meeting
Wednesday, April 14th, 2010
Shelburne Regional High School
Table of Contents
Page 3
Public Meeting Notes
Page 17
Written / E-Mail Submissions
Page 19
Appendix A – Public feedback form
Page 20
Appendix B – Emergency Department
Accountability Act
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PUBLIC MEETING NOTES
On Wednesday, April 14, 2010, South West Health held a public meeting at the
Shelburne Regional High School in order to consult with the public and gather input,
feedback and solutions about how to keep the local Emergency Department open 24
hours a day, seven days a week.
Approximately 65 people attended this public meeting which was held in accordance
with the provincial Emergency Department Accountability Act (see Appendix B). The
following are notes taken at the meeting. In most cases, names of audience members have
been removed.
Opening Remarks: Gerald Pottier, South West Health Board Chair
Good evening everyone.
My name is Gerald Pottier, and I am the Chair of the South West Health Board of
Directors. On behalf of the Board of Directors, as well as the Management and Staff of
South West Health, I welcome you all, and thank you for coming to our consultation
session.
I am sure we will have plenty of good ideas and good discussion tonight.
I know the local Emergency Department is an issue that is very near and dear to many of
you. I want to assure you that we feel the same way.
That is why South West Health is committed to working with staff, physicians, our
community and the Department of Health to keep the Roseway Hospital Emergency
Department OPEN 24 hours a day, 7 days a week.
This is our goal. But as you are aware, this is not always possible.
The Roseway Hospital Emergency Department is closed temporarily from time-to-time
mainly because of physician shortages.
Tonight we want to talk about some of things we are doing to keep our Emergency
Department open. But more importantly…we want to hear from you.
We want your input, opinions & ideas about how we can keep our Emergency
Department open consistently.
Getting public input on important health care issues is an important part of being
accountable to the communities we serve.
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We do this through our Community Health Boards, and our Annual General Meetings
which we host in a different community each year.
And I am glad to see some members of the Shelburne County Community Health Board
with us tonight.
Consulting with the public about local Emergency Departments is also the focus of the
new Provincial Emergency Department Accountability Act. This Provincial Legislation
was passed last October. The Act basically says that District Health Authorities must
consult with communities where the local Emergency Department has experienced a
pattern of closures.
Just last month we held a consultation in Digby and I know many health districts in Nova
Scotia are holding similar public meetings in their communities.
According to the Act, we are to consider community solutions to keep open the
Emergency Department, or to provide alternative health services. All of the input we
collect will be shared directly with the Minister of Health – unedited and unfiltered.
Before we get started, I would like to introduce some of the staff of South West Health
who are with us today…
Blaise MacNeil, CEO, South West Health
Jodi Ybarra, Site Manager, Roseway Hospital
Debbie Sutherland, Nurse Manager, Roseway Hospital
Dr. John Keeler, Deputy Chief of Medical Staff
Dr. Edwin Janke, Chief of Medical Staff
Cathy Blades, Vice President, Clinical Care
Joyce d’Entremont, District Director of Nursing
Kevin Vickery, District Director of Human Resources
Shirley Watson-Poole, Physician Recruitment Manager
Fraser Mooney, Director of Communications
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Background: Jodi Ybarra, Site Manager, Roseway Hospital
Thank you Gerald. And thank you to everyone for coming tonight.
Over the past few years we have had some challenges keeping our Emergency
Department open 24 / 7.
From month-to-month, we saw a pretty consistent increase in the number of hours the
Emergency Department was closed in 2009, compared to 2008. This was due mostly to
the fact we weren’t able to arrange physician coverage at these times. We have also seen
some staffing pressures related to Nurses.
But I am happy to report we have had some positive improvements in 2010. For the past
two months, we have not had any ER closures at all, which has not happened since April
of 2008.
This is thanks to our successful recruitment efforts and the dedication of our Physicians
and nursing staff who provide Emergency Department coverage.
I want to thank our regular Emergency Department Physicians:
Dr. John Keeler
Dr. Wouna Chaloner
Dr. Eoghan (Owen) O’Sullivan
Dr. Mark Riley
Dr. Charles Wambulwa
As well, we have a number of Physicians who provide locum – or temporary coverage.
These physicians are:
Dr. Margaret Benne
Dr. Tobi Benne
Dr. Guy Lefebvre
We have had great cooperation from our physicians and staff, but we do anticipate we
will see some more scheduled closures in the coming months. Whenever a physician goes
on vacation or a locum physician is unavailable, it creates gap in the schedule that can be
difficult to fill.
Shortage of Family Physicians creates a twofold problem -- Emergency Department
closures and people without a Family Physician must go to Emergency Department for
health services that are not “emergencies” (prescription refills, etc.)
That is why recruitment and retention is so important.
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As a district, we are pleased to work in partnership with the municipal governments in
Shelburne County as well as the local physician recruitment committee. Together, we
have been able to share ideas and develop solutions for the current situation.
Dr. John Keeler has been very involved in recruiting new physicians and planning around
Emergency Department coverage.
I would like to ask Dr. Keeler to share his thoughts about our current situation…
Dr. John Keeler’s Overview
Good evening and thank you for coming out tonight.
In 2008 the Recruitment Committee was started and I was part of that committee. A lot
of great ideas came forward from the group to look into recruitment that hadn’t been
looked at before. I can’t think of each individual name but I know that each individual
came from different backgrounds.
Recruitment efforts included attendance at job fairs, mail-out campaigns and the design
of a website. As a result, a lot of physicians have come over the past year, including
International Medical Graduates. My role in the committee has been to introduce them to
the community and show them what the community had to offer both professionally and
personally.
We have also had the opportunity to work with Shirley Watson-Poole (South West
Health Physician Recruitment Manager) and in turn work with CAPP physicians. We
have had two in the past few years as well as two in Barrington.
In addition to our local physicians, we have been very fortunate in the past few months
with our ER Rota due to the arrival of Dr. Wambulwa as well as coverage by three
locums (Dr. Guy Lefebvre, Dr. Tobi Benne & Dr. Margaret Benne) who have provided
huge assistance for us.
I would also like to say that recruitment takes a lot of effort and includes the help of the
community.
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Blaise MacNeil, CEO, Overview
We have talked about some of the background around the temporary Emergency
Department closures. And we talked about how we are working with the community on
recruitment initiatives and the use of locum physicians to cover gaps in the schedule.
Before we turn it over to you, I would like to talk a little about what some of our options
may be on and ongoing basis for improving access to health services and keeping our
Emergency Department open 24/7.
We are continuing to work with communities to identify, attract and recruit health care
professionals.
We are also exploring ways to expand the success of the CAPP program (international
medical graduates) to all three counties.
And we will continue to work with physicians and the Department of Health to advocate
for changes to payment structure for Emergency Department shifts to match night time,
weekend and holiday rates.
We also would like to find ways to support primary care Family Physicians so they can
provide full range of support to their patients – for example, extended hours – whether
they are in solo or group practices.
We would like to work towards more primary care practitioners, like Nurse Practitioners
in communities. As well as explore the mix of health professionals in the Emergency
Department (Paramedics, Physician Assistants, etc.). This may require changes to
legislation, expanded scopes of practice, policy framework, etc.
As you may know, the Department of Health has an Emergency Room Advisor - Dr.
John Ross – who has been visiting ERs around the province. He is developing
recommendations around the Emergency Department utilization. He still has some work
to do, and some ERs to visit, but he issued his preliminary report last week. The report
focused on a number of key areas, including:
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•
•
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The need for provincial emergency room standards
The need for increased access to primary health care services to provide better
care to people with non-urgent medical and chronic care needs
The need to collect and share reliable data on emergency services in order to
provide safe, quality care, and
The need to address emergency services as a provincial system so that all Nova
Scotians can have equal access to quality care.
We look forward to Dr. Ross’ final report and working with the Department of Health
and the community to see how we can ensure reliable services at our local Emergency
Department.
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Now it’s your turn. I know you have a lot on your mind and we are looking forward to
hearing your input. We will be transcribing, as best we can, what you have to say on the
screen to make sure we accurately capture your thoughts and ideas.
To help frame the discussion and generate comments, we have developed some questions
that will also help keep us focused on the issue of Emergency Department
Accountability.
We do have a lot of people who want to speak, so I would ask that you try to keep your
comments to a few minutes each so we can hear from as many people as possible. Also,
if anyone has written statements, please keep them brief to allow others a chance. Written
statements can be handed in and will be included in our submission to the Minister of
Health.
People can also give input by e-mail, fax or regular mail. So, up for discussion, we have
the following questions…
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What are your suggestions for keeping Emergency Departments open 24/7?
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What alternative health services do you think should be in place when Emergency
Departments are closed?
•
What do you think is the best way to address the health care needs in your
community?
•
What do you see as barriers to recruitment?
•
What makes a welcoming community? What can we do as a community to attract
& retain health care professionals?
•
What is the best way to deliver / receive health care services?
•
What role does the community have in promoting wellness?
•
What worked well with this consultation process and how might we improve it?
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Public Suggestions/Comments/Questions
RESIDENT: I am with the local Community Health Board. I want to refer you to Bill
52 which is the act referring to the Emergency Accountability Act. This act states that
the DHA’s (District Health Authorities) are responsible to address issues of
overcrowding and wait times. I wonder if you might give us some specifics on what your
plans are with Roseway.
BLAISE MACNEIL: Jodi alluded to some of this in her speech. We are trying to look
at avoiding closures and provide as much notice as possible. We alert the community, as
well as EHS when these closures happen. So far we have not had closures at Yarmouth
Regional Hospital which in turn helps the situation. We are also working very closely
with the Recruitment Committee and have had some success.
RESIDENT: I am under the impression there are certain physicians, namely in
Barrington, that use our hospital for their patients but they don’t cover the ER.
BLAISE MACNEIL: We don’t employ physicians, they are independent employees.
They are using the resources of the district to treat patients.
RESIDENT: Who is liable for a malpractice suit if a physician is not available to treat
their patients after 5 o’clock on a certain day?
BLAISE: I would need more information. If there is an issue between a physician and a
patient and the physician does not have office hours after 5 p.m., his voice mail should
indicate to call 911 during an emergency or visit the local ER after hours.
DR. KEELER: It’s the physician’s responsibility to get the message out where a patient
can get help if needed, where they can go to get care during those times the physician is
not working.
Physicians in some communities have a rota within their own group to do after-hours on
call. Barrington had that system years ago when they had a full complement of
physicians. This is hard to maintain. If there are not enough physicians, things start to fall
to pieces.
RESIDENT: Do we need the hospital open 24/7?
DR. KEELER: Until somebody comes up with a better plan, the answer is yes. The
community want 24/7 coverage, that’s the current model we all work under. Unless
somebody has a different idea.
RESIDENT: Should we not cover the evening and night shift and leave the day shift
empty?
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DR. KEELER: That is why Dr. Ross is visiting each district to look at other ways to do
things. Until they get good hard data, I don’t’ think anyone can say what is the best
model of care.
RESIDENT: Having EHS on call would be an option. This is very costly.
DR. KEELER: It is not so great when you have a baby sick and you need them seen by
a physician. EHS is equipped to look after emergencies such as chest pain and transport
these patients to hospital. I don’t think there is a better way then having access to health
care in your community 24/7.
DR. JANKE: Dr. Ross (in his interim report) discusses the need to make EHS
affordable to everyone one way or another. I hope this is addressed in the end.
RESIDENT: We have worked hard as a Physician Recruitment committee as
volunteers. What can the district do to better support what we are doing to help it be more
successful?
BLAISE MACNEIL: What the district can do, and is doing, is being a resource to
support your efforts. This includes attending job fairs and promoting the district. We also
support your website with the district website. We are working together to help support a
modern facility to help attract physicians. The best salespeople for the community are the
people in the community and that is where the best success is.
RESIDENT: We don’t have any funds to pay the bonuses and the fees that the
physicians coming out of medical school want. Can the district support us with this? I
would also like to see more communication with the district for our efforts. We get a lot
of support from Jodi Ybarra however, not from upper management.
BLAISE MACNEIL: Your point is well taken.
RESIDENT: It is my understanding that other DHA’s have money in their budgets
dedicated to physician recruitment while our DHA hasn’t taken that same approach. A
second part to that is I am wondering about the competition between Roseway and
Yarmouth with health dollars. Is there an equitable distribution? Are we getting what we
need in this area?
BLAISE MACNEIL: I am not aware of any DHA’s having monies. Foundations help
with these efforts. We do help with expenses with attending job fairs which is included in
our operational budget. We don’t’ have monies to hand out to communities to recruit.
We have requested funding assistance in partnership with the community and foundation
to help with construction of a new medical clinic.
RESIDENT: Are we under threat of closure?
BLAISE MACNEIL: Closure by whom?
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RESIDENT: We see in the paper that there is a threat of the provincial government
shutting down services in rural areas.
BLAISE MACNEIL: I see nothing in Dr. Ross’s preliminary report (that would
indicate plans for closure). The report is available if requested. There may be changes in
the current delivery of service as a result of his review and findings. But nothing pertains
to closures which is part of the reason for these consultations.
RESIDENT: My husband runs the local sailing school. Part of running a business is the
insurance asked what there is available for emergency care services. What would
changes on the deliver of service impact on insurance for these small businesses? Is that
going to affect our attractiveness for economic development?
RESIDENT: Could you inform us about the DHA’s relationship with DoctorsNS and
Dalhousie Medical School? The question comes from the desire to attract physicians
from other countries. There are other countries we may be able to recruit from such as
Australia, etc. We need to increase the flexibility of recruiting foreign doctors.
BLAISE MACNEIL: It is not the responsibility of DoctorsNS to recruit foreign
physicians. This is done by the Department of Health Physician Services. The College of
Physicians and Surgeons is responsible for credentialing foreign physicians. We work
closely with these agencies closely.
RESIDENT: The government makes the DHA responsible for the recruitment of
physicians so we depend on you to recruit them. We depend on you to lobby on our
behalf (in regards to licensing and credentialing requirements for foreign trained
physicians). Why are they not allowing other doctors from the UK to practice?
BLAISE MACNEIL: They are individually assessed. It doesn’t matter where they
come from. It is more likely a US physician meets the criteria (needed to practice in
Nova Scotia) more closely. But it is a highly individualized assessment.
RESIDENT: Saskatchewan and Newfoundland are making the exception. It’s an avenue
worth exploring.
RESIDENT: There are no closures in the ER in Yarmouth? How many physicians do
you have on the rota?
BLAISE MACNEIL: I don’t know offhand.
RESIDENT: How many visits in a year?
BLAISE MACNEIL: 65-68000 approx.
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RESIDENT: What about the staffing? Do you have any connection with the Master
Agreement (between DoctorsNS and the Department of Health)? The Master Agreement
allows for a huge financial budget to recruit and retain doctors.
DR. JANKE: I don’t think there is any connection. It deals with physician
remuneration and certain benefits while on call.
RESIDENT: There is a big fund that is made available for recruitment and retention on
page 26 of the Master Agreement.
DR. JANKE: Most of the money is available for specialized areas.
RESIDENT: Is the ER doc paid the same salary in Shelburne as the ER doc in
Yarmouth? Are there any changes to that?
BLAISE MACNEIL: We would like to see changes on how the payments are divided
around remuneration between evening and day shifts. We have addressed this with the
Department of Health.
RESIDENT: I have a question with regards to some doctors in Barrington not serving in
the ER. Is there some way to tie the Master Agreement to doctors serving in the
Emergency Department? Can the link be made so doctors have to work in the ER as well
as office hours?
BLAISE MACNEIL: The agreement is between the Department of Health and Doctors
Nova Scotia.
RESIDENT: We want to avoid the bidding war (between communities for doctors).
Municipalities continue to face downloading for costs related to capital infrastructure.
We want to serve our communities so do we invest in these projects? How can we argue
through the DHA for our DHA’s budgets to include some of these costs?
BLAISE MACNEIL: You’re right. Some municipalities have chosen to work in
partnership with us. Some have chosen to go out and fund these projects themselves. We
can reflect your comments back (to the Department of Health).
RESIDENT: The local Physician Recruitment committee has expanded our scope to
include the recruitment and retention of other health care professionals. What is the
DHA’s approach to recruitment beyond physicians?
BLAISE MACNEIL: There are two positive things. There is a satellite School of
Nursing in Yarmouth which allows us to be able to recruit locally. My staff have also
gone out to high schools to talk to students. With respect to nurses and others health
related professional, if you can get students interested, the turn around is good. I would
encourage communities to contact us if they know of someone who is planning on going
into any of these fields.
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RESIDENTS: Who determines the salaries of physicians in the ER in each area?
BLAISE MACNEIL: It is a negotiation between DoctorsNS and Physician Services of
the Department of Health.
RESIDENT: Quite often younger doctors also have a spouse who is a professional that
is not in the health care field. In smaller areas like Shelburne there is often no work for
them.
BLAISE MACNEIL: Absolutely.
RESIDENT: How adequate is your budget to meet all of the responsibilities of the
DHA? (Question from a Municipal Councilor)
BLAISE MACNEIL: How adequate is your budget? Our needs exceed resources. We
try to allocate to where the greatest need is across the district, for example dialysis,
chemotherapy, physician. recruitment.
RESIDENT: Doctors are sometimes recruited with a defined license and have to be
mentored for 200 hours before they can get a license. This involves a full steady day of
training and teaching. At the end of that time when they have their license they often
leave and go to another area. This seems to be quite often an entry point for them
combined with a bidding war. That concerns me because we look at monies that will
come from Municipal taxes or from our Foundations, which don’t have as many
donations as in the past. We see a picture where a community can become destitute not
to mention the residents worrying about paying taxes and what is going to become of this
situation.
RESIDENT: About a week ago I went to the Roseway Hospital. I needed an x-ray and
the next day I looked on the requisition and it stated that I had to call a number at
Yarmouth Hospital to make an appointment for Roseway. I called Yarmouth and
explained that it would be beneficial if I could have it done ASAP as per my doctors
request. The lady informed me I couldn’t get one today (Tuesday) and would have to wait
until Friday. I was told I could go to Yarmouth. Imagine driving all the way to Yarmouth
for an x-ray. I then called Roseway and had an appointment in a half-hour. When I got
there there was no one waiting for an x-ray. Are they trying to get rid of this service in
Shelburne? I would not want to have to get to the day where I had to go to Yarmouth -- I
would go the other way first.
BLAISE MACNEIL: Dr. Keeler will follow up with this at the end of the meeting.
RESIDENT: I have called the line trying to book an appointment and waited 25 minutes
to get an appointment and ended up listing to the Yarmouth radio. If I wanted to listen to
the radio I would turn it on at home. We need to make our appointments at Roseway not
Yarmouth.
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RESIDENT: Can we distribute some of the District Health Authority’s costs to other
departments to get better health care services? The Department of Community Services
and Seniors may be able to contribute to housing. If you focus your health care efforts
across departments you are then able to deliver better health care services. Is there some
way to complement services?
RESIDENT: I don’t have any expertise in the medical field but a lot of expertise in
dealing with the provincial government. The Provincial Government so often wants to
make a one-size-fits-all for all areas.
DR. KEELER: I am involved in mentoring some of these CAPP physicians. We have
been fortunate to have had two or three who have stayed a long time. One stayed five
years. Five years is a long time. For those docs who spend their time mentoring these
people, we hope they do stay a long time. However, because of where they come from, it
is a huge transition. As a community we put our best foot forward and hope they grow to
love it. They often move to areas where they have other family. The CAPP program is
one of the few programs that is successful in bringing doctors here along with the
Dalhousie Medical Program. The CAPP program is the one program I see as more of a
success story rather than a failure.
DR. RAHMAN: In regards to recruiting foreign graduates, the district has taken the
initiative in helping these physicians come to the area. I am one of them. This
community is great and hopefully we will stay.
BLAISE MACNEIL: You have to take some chances along the way. One of the things
we have done is we have adopted the IMG’s (International Medical Graduates). They
may go somewhere else once they are qualified but they are a great asset while they are
here. We get years of service we would not otherwise have.
RESIDENT: If someone arrives at the hospital emergency room in the wee hours of the
morning and it is closed, is there a locked door?
JODI YBARRA: No, there is an Registered Nurse and a triage nurse in the department.
RESIDENT: I would like to see when a doctor or a nurse determines if these patients
require an ambulance, then the province should pay for this, not the patient.
BLAISE MACNEIL: There is no charge for an ambulance from hospital to hospital.
Dr. Ross is currently looking at this issue with regards to ambulance fees.
RESIDENT: When a patient is at home and having a heart attack and has to call an
ambulance, they should not have to pay.
BLAISE: It is a co-pay. They are only paying a fraction of the cost.
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RESIDENT: I understand if a physician orders the ambulance you don’t have to pay?
We also have 811 where nurses assess a patient on the phone.
DR. KEELER: I think it would be tough to make a determination of acuity over the
phone. A lot of nurses will say go to an ER. I can’t speak to the cost. To my knowledge,
if a physician gave advice to get an ambulance this does not affect the cost. The only
time there is no cost for an ambulance is when a patient is transferred from hospital to
hospital.
BLAISE: I called 811 and was told to go to the ER department.
RESIDENT: Could I have clarification of what co-pay is? I had to have an ambulance
not long ago. The complete bill came to my house and I had to pay it. I did have
insurance that covered the cost but to my knowledge no one else paid any part of the bill.
BLAISE: To my knowledge the province reimburses EHS for part of the cost.
RESIDENT: What is the cost?
BLAISE MACNEIL: I am not sure.
RESIDENT: Whether or not we live in Shelburne County, is it in our best interest to be
in a DHA that is structured as it is? I know of instances where patients have to be sent to
Halifax once going to Yarmouth.
BLAISE MACNEIL: Referral of a patient to another facility is a physician decision.
RESIDENT: When doctors come and go through the mentorship program we are
assuming they are leaving for money. Perhaps it isn’t money. How can we as a
community determine what they are leaving for?
SHIRLEY WATSON–POOLE: We often talk to physicians to find out why they have
left but do not do a formal exit interview. It is usually a family decision why they leave.
DR. KEELER: They leave because it is a family decision or perhaps for culture
reasons. What do we do? We do what we do best—offer a well rounded enjoyable life
style.
SHIRLEY WATSON-POOLE: We don’t have a formal exit interview. We often have
conversations with them and often know their reasons for leaving. Sometimes there is
nothing necessarily wrong with the community but there are other opportunities in other
areas for them. We also have a lot of circumstances where they come and stay. We have
had one retire after 37 years of services.
DR. JANKE: Family and culture are the main reasons for leaving.
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RESIDENT: In our area we try to welcome newcomers. I moved here 23 years ago.
Many people share kindness and friendship and help us understand this area. Is there a
way to help the families of the physicians to make them feel more welcome in our
community of Shelburne County? We have over the last four years developed a
volunteer program for Care Clowns. We (the Clowns) visit the Manor and Hospital to
bring humor to those staff and patients at these facilities. Maybe there is a way we can be
more welcoming.
JODI YBARRA: One of the things we are looking at with the Physician Recruitment
committee is looking at retention of these health care professionals and their families.
Any suggestions you have would be more than welcome.
BLAISE MACNEIL: The legislation requiring consultation is ongoing, so we will be
back. We are grateful you took the time to come and join us. Is 7 p.m. a good time for
the meeting?
RESIDENTS: Yes
GERALD POTTIER: As chairman of the board I am convinced that we do not treat
one area better than another. Yarmouth may appear to have more, but this may be
because of the larger number of people therefore requiring more services. We must do
everything we can to provide the best service we can to the community of Shelburne.
You can still submit your thoughts and questions via email or fax.
Thank you.
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WRITTEN / E-MAIL SUBMISSIONS
Hello
Thanks for asking for ideas.
I saw it on TV, and I think it is true, a GP in the USA has 6 to 8 people working at filing
insurance forms and billing patients. If you are advertising in the USA you might mention
that here in Canada GPs can have a medical pratice with just one employee. A GP can focus
on medicine without all of the staff problems and expense.
If you are advertising in western Canada, ie. Vancouver, you might mention that here in
Nova Scotia you can buy a very nice house for way less than the average small condo in
Vancouver, where the average price for a home is one million dollars.
Also part of what really needs to happen is for Dalhousie to start educating more doctors.
Since 1970 they have not increased enrollment very much, not as much as we really need.
Offer a student a free education if he will be a GP in rural Nova Scotia. See graph below.
Sincerely
Jim Kimbrell
a link about educating doctors
http://www.afmc.ca/index-e.php
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What do YOU think?
What are your suggestions for keeping Emergency Departments open 24/7?
What alternative health services do you think should be in place when
Emergency Departments are closed?
What do you think is the best way to address the health needs in your
community?
What do you see as barriers to recruitment?
What makes a welcoming community? What can we do as a community to attract
& retain health care professionals?
What is the best way to deliver / receive health care services?
What role does the community have in promoting wellness?
What worked well with this consultation process and how might we improve it?
Send your response to:
Blaise MacNeil, CEO, South West Health
60 Vancouver Street, Yarmouth, Nova Scotia, B5A 2P5
742-0369 (fax)
[email protected]
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BILL NO. 52
(as passed, with amendments)
1st Session, 61st General Assembly
Nova Scotia
58 Elizabeth II, 2009
Government Bill
Emergency Department Accountability Act
CHAPTER 4 OF THE ACTS OF 2009
The Honourable Maureen MacDonald
Minister of Health
An Act to Provide Accountability
Respecting Hospital Emergency Departments
WHEREAS keeping hospital emergency departments open to provide safe, quality care
and reducing wait times in health care is a Government of Nova Scotia responsibility;
AND WHEREAS district health authorities are responsible for effective management
strategies throughout the health and hospital system, which have an impact on emergency
department overcrowding and wait times, including appropriate staffing, training,
consistency of standards and planning to ensure patient access to safe and timely care
across Nova Scotia;
Therefore be it enacted by the Governor and Assembly as follows:
1 This Act may be cited as the Emergency Department Accountability Act.
2 The purpose of this Act is to provide public accountability to communities respecting
emergency departments.
3 In this Act,
(a) "closure" of a particular emergency department means a closure that results in there
being no emergency department services available to the public from that emergency
department;
(b) "district health authority" means a district health authority as defined in the Health
Authorities Act;
(c) "emergency department" means an emergency department operated by a district
health authority;
(d) "Minister" means the Minister of Health.
4 (1) Where the emergency department of a district health authority has experienced an
ongoing pattern of closure of the emergency department since the last public forum held
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by the district health authority pursuant to Section 18 of the Health Authorities Act, the
district health authority shall consult with the community served by the emergency
department as part of its next public forum pursuant to that Act.
(2) The consultation must include consideration of proposed community solutions to keep
open or re-open the emergency department or to provide alternative health services.
5 (1) The district health authority shall report, as soon as it is aware, of a potential closure
and the reason for such closure to the Minister.
(2) The district health authority shall report to the Minister within a reasonable period of
time on all consultations pursuant to this Act and the actions taken or to be taken by the
district health authority as a result of the consultations.
6 The Minister shall table annually a report in the House of Assembly that provides
(a) the dates that all emergency rooms in the Province were closed and the reason for the
closures, both by individual hospitals within a district health authority and in a districtby-district format;
(b) the nature and outcome of all consultations reported pursuant to subsection 5(2); and
(c) the actions taken or to be taken by the district health authority as a result of the
consultations reported pursuant to subsection 5(2).
7 This Act comes into force on such day as the Governor in Council orders and declares
by proclamation.
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