N.S. model needs scrutiny
Published on January 16, 2013
Letters to the Editor (The Guardian)
We are encouraged by the health minister of P.E.I. addressing emergency issues by announcing a study of emergency department wait times and by considering alternative care at the Western Hospital in Alberton.
The Nova Scotian model has attracted a lot of national attention with respect to the delivery of emergency care in rural environments. It has not been endorsed by Canada’s emergency physicians and it remains to be seen as to whether this model will hold up to public scrutiny when tested with critically ill patients.
This model assumes that the great preponderance of emergency visits are basically for primary care type problems that can be handled by family physicians and nurse practitioners. Seriously ill patients will be attempted to be stabilized and transferred to regional centres.
Indeed all Canadian emergency departments can expect that critically ill patients will represent substantially less than five per cent of their total patient volumes. Nevertheless all Canadian emergency departments are structured to be able to handle the critically ill.
To plan for strictly low acuity patients is contrary to the Canadian model and threatens the health and safety of all Canadians in that one never knows when critical illness or injury will strike.
We watch the Nova Scotia experiment with great interest but recognize that it is only an experiment.
There are other models, of course, including optimization of each local ER, where possible, and integrating each department into a regional system of care.
Collaborative health centres may have some value for primary care problems but they are not replacements for an accredited emergency department.
Alan Drummond MD,
Canadian Association of Emergency Physicians,