Collaborative emergency centre 'a great improvement'

TATAMAGOUCHE - So far, Malcolm Roberts is impressed.

"Yes I think it's a great improvement," the chairman of the Community Health Board in Tatamagouche said Wednesday during the official opening of the new collaborative emergency centre (CEC) at the Lillian Fraser Memorial Hospital.

"In the past people were very concerned locally that the hospital was closed and sometimes in an emergency people aren't thinking correctly," continued Roberts. "They automatically head towards a hospital and get here and find out it was closed."

That was the past.

Since the centre opened in July, the emergency department has not experienced any closures, a vast departure from recent years when notices of temporary closures became the norm.

According to government figures, between April 2010 and March 2011, the hospital's emergency department was temporarily closed for a total of 1,952, or more than 146 hours each month.

With the introduction of the new CEC, which has been open continuously, however, more than 1,500 patients have been seen since the beginning of July and patient wait times have been reduced thanks to a team-based approach between on-call doctors, nurses and paramedics that offers continuity of care.

Between 8 p.m. and 8 a.m., a team that consists of a primary care paramedic and a registered nurse staff the centre to ensure patients get the care they need. An EHS oversight physician provides assistance by phone.

"This is a great system," Roberts said, "I've had no complaints."

In officially opening the centre, the third in the province, Dexter described the move as "another milestone" in the Better Care Sooner Program, introduced by the government to improve health care for rural Nova Scotians.

"I have always said that the program must be about delivering services in rural communities," Dexter said, during a media interview following the official announcement. "It has to be about changing the model in order to ensure that people are getting the care they need when and where they need it. And that's what the collaborative emergency centres do. They stop emergency closures."

Some opposition MLAs, however, were not as enthusiastic about the new model, despite the fact that other provinces are also starting to buy into the plan.

"Well I think before you can really talk about how successful a model is, you have to have a period of implementation," Colchester North Liberal MLA Karen Casey said, from the site.

While wishing "them every success," she said, given that the implementation process is in its early stages, the roles and responsibilities of the individuals involved in making the CEC work will determine its success over the long term.

"And that's very much dependent upon the doctors, the nurse practitioner and the paramedics who form that team to provide that 24-7 care."

As long as everyone continues to play their part, Casey said, "... then it will work.

"But I don't want to be premature in my excitement about it."

Conservative health critic Chris d'Entremont was even harsher in his assessment of the plan, based on the premise that it was not what Dexter promised to deliver.

"We hope that the CEC concept works. We see the communities working well together. We see the hospitals and the medical personnel working well together," he said.

"The thing that we criticize here is that this is not what the government promised during the last election. They promised to have emergency rooms open 24/7 across Nova Scotia to sort of fix that problem of chronic closures. This is a long ways from a full emergency room. This is a clinic that has a 24-hour capability."

While the CEC model may work in many cases, he said, in situations involving heart attacks or strokes, the time it takes to assess a patient before shipping them on to a fully operational emergency department could be crucial.

"Time is life," he said. "We're critical of the fact that what we're seeing now, if you are still in an emergency medical situation you might as well just call 911. Because what is going to happen here is that if you are pronounced further beyond their capability here, you are going to be shipped into an ambulance to Truro anyway."