Rural ERs in critical condition-study

The report titled Changing Nova Scotia’s Healthcare System: Creating Sustainability through Transformation suggested changes that propose drastic health care changes to the entire province with emphasis on rural settings.

“This must include the difficult decision to shift everything other than acute care out of acute care hospitals, even when doing so upsets traditional patterns of service for smaller and rural communities,” the report read.

Two major recommendations for rural hospitals, including Roseway Hospital is to; review emergency department staffing issues to determine if services are sustainable in the long term and to review the overall staffing model as part of Rural Health Strategy.

Recently, with one physician short in the Emergency Department (ED), Roseway has seen some closures in the ED but not nearly as much as it could have been said Arthur Blades, Chair of the CHB.

“We totally support our doctors,” he said of their efforts at running the ED. Some of the solutions to the doctor shortage have been to have locum doctors available to fill in the missing shifts to keep the ED open.

According to a 2007 Roseway Hospital Site Manager’s Report, there have been 16,270 total patient visits to the ED that year.

Harold Hart, member of the CHB points out that if the government were to filter out the emergency department at Roseway, there would be no hospital left.

In response, the CHB has directed a letter to the South West District Health Authority (DHA), the agency responsible for the administration and operation of Roseway Hospital and to the Department of Health.

“Our stance is no closure…it’s just not acceptable,” said Blades.

The premier has made a statement the day the study was released in the press that he does not intend to close EDs in Nova Scotia but the CHB is not buying it.

“Experience has shown that studies/reviews in the past have resulted in losses of services,” said the letter.

The letter further pointed out that residents in Shelburne County are 60 to 90 minutes away from the nearest hospital.

One section of the report titled, The Special Case of Small Community Emergency Departments where it outlines the inappropriate use of rural EDs as substitutes for primary healthcare clinics and doctors’ offices.

It recommended that instead communities rely on the Emergency Health Services (EHS) for emergency care.

“It is positioned to be responsive and reachable for all areas of the Province; however, it is a greatly underutilized resource,” read the report.

But, the CHB disagreed with this logic.

“Calling an ambulance for ED services is an expensive solution most people cannot afford,” it said in the letter.

The CHB is not fighting everything though, it does realize that changes must be made and are willing to work with the authority and develop an alternate strategy.

“It is an issue we have to stay ahead of,” said Hart. “We can’t wait until they make a decision to try to change their minds.”