The collaborative emergency centre (CEC) in Pugwash is leading the way in closures of hospital emergency rooms across the province.
The province’s Health and Wellness department recently released its Annual Accountability Report on Emergency Departments. From April 1, 2017, to March 31, 2018, the North Cumberland Memorial Hospital in Pugwash was closed to the public 25 per cent of the time.
The report is prepared annually under the Emergency Department Accountability Act, which requires the Nova Scotia Health Authority and IWK Health Centre report on all their closures of emergency departments. The two bodies also have to hold public consultations in communities where ongoing closures are a pattern, and they must report outcomes of those consultations with the department minister.
In his accountability statement, Minister Randy Delorey says, “Emergency department closures that are unpredictable and unplanned are considered temporary closures.” Many of those closures, he said, are the result of unavailability of emergency staff, such as physicians, nurses, and paramedics.
The hospitals in both Pugwash and Tatamagouche are home to the collaborative emergency centres, and their hours of operation can vary by facility.
In fiscal year 2015-16, the Lillian Fraser Memorial Hospital saw 99 hours of closure. That number jumped to 410 hours in 2016-17, which saw the health authority change the hours of operation on Oct. 2, 2017. Instead of being open 24/7, the CEC in Tatamagouche is now open 8 a.m. to 4 p.m. Monday to Friday, and 8 a.m. to 8 p.m. Saturday and Sunday. It’s also open from 8 p.m. to 8 a.m. with a team of paramedics and registered nurses, with a physician providing oversight over the phone.
“These changes were made to provide more consistent ED services, to prevent sporadic closures, and to protect local physicians from burnout due to high patient volumes coming from outside the catchment area,” reads the report.
With the change in Tatamagouche, the CEC was open 96 per cent of its scheduled hours during fiscal year 2017-18, meaning it was closed a total of 356 hours.
In Pugwash, the CEC is scheduled to be open 24/7, however many daylight hours during the week have seen closures due to physician unavailability. In 2017-18, it was closed for 2,212 hours, or 25 per cent of the time.
Pugwash had the highest number of hours closed, with Glace Bay Health Care Facility coming in with closures in the amount of 1,835 hours, or 21 per cent.
In a previous interview for The Light, Delorey said steps were being taken to address the frequent closures in Pugwash, as well as the rest of the province.
“The health authority makes every effort possible to fill those shifts, and sometimes closures are necessary for not having resources in place at that time. Steps are being taken – it’s not just Pugwash seeing this,” he said.
In late 2017, the province awarded a contract to Architecture49 to design a new hospital for the area. The province, Delorey said, was still waiting on a design of the facility.
He said the new facility, to replace the one that’s more than 50 years old, would make the area more attractive to physicians.
““Those graduating now want to be working in a facility that’s of modern design that supports their training,” said Delorey. “Having a new facility does make it more attractive.”
The health authority hosted a public consultation in Pugwash on March 25 of last year that saw seven speakers ranging from the Northern Zone’s medical executive director, to the zone’s director of primary health care. During that meeting, many questions were put forth about CECs and what is offered, so the health authority put together an education campaign on the CEC model. The April 2018 edition of The Light carried a story with Barbie Cook, site leader, about the concerns, and the full report stemming from the public consultation was also posted online.