Nova Scotia towns plagued by ER closures anxious for collaborative centres update

The future of emergency medicine in the province could be revealed as soon as this fall, and for some communities it can't come soon enough.

Before the last provincial election the former NDP government was rolling out collaborative emergency centres (CECs) in communities that faced chronic emergency department closures.

The idea was the sites would provide same- or next-day primary care access while still offering some emergency services with the help of nurses, paramedics and doctors.

Communities left waiting for their CEC

Eight CECs were established around the province and six more were tapped to come. A report on the existing sites in December 2014 showed CECs helped reduce closures, improved access and called for even more.

One of the sites expected to come next was in Lunenburg, where to this day Fishermen's Memorial Hospital experiences periodic emergency room closures.

David Patrick, a former member of the community health board who worked on the plan, said they were motivated by getting the area the services it needed as well as possibly helping doctor recruitment.

Election 'seemed to put everything on hold'

Patrick said a lot of work was done on the issue.

"We thought we were getting pretty close to having the final plans in place," he said.

"We had reached the point of seeing some options as far as the actual floor plans. But then there was an election and that seemed to put everything on hold."

Following the last provincial election, the Liberal government merged the district health authorities and the new entity began reviewing programs and services on a province-wide level.

A province-wide look at emergency care

Dr. Dave Petrie, chief of the central zone's department of emergency medicine and co-lead on the planning for the emergency medicine program of care, said the work being done builds on previous reports.

Part of the work is categorizing all the emergency departments in the province from level one (tertiary/teaching sites) to level four (CECs and small community sites).

The aim of CECs is improving patient outcomes, said Petrie. Decisions must be made in terms of what will continue that improvement and how it links into the entire emergency system. For example, the 2014 CEC report pointed out that some sites might not need to operate around the clock if they are close to larger sites.

'How does it all fit together?'

"The whole planning comes into a broader system's perspective," he said.

"There was, I guess, touching on the breaks a little bit to say, 'OK, how does it all fit together?' Let's not just move ahead and jump in and put something here when we don't know how it relates to the level three [emergency department] in that zone or the level two in that area."

It's a conversation that's happening across North America, said Petrie.

Frustrated but hopeful

While he's frustrated by the delays, Patrick said he isn't surprised. He's watched other system restructuring and knows it can take a while for the dust to settle.

But when it does, Patrick hopes that final report reflects the collaborative work done not just for the Lunenburg hospital, but also the one in Liverpool and Bridgewater.