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Saskatchewan seeks ways to improve rural emergency care

The challenge of keeping rural Saskatchewan emergency rooms open could be alleviated by adopting a Nova Scotia health-care model, says Saskatchewan’s minister responsible for rural and remote health.

Randy Weekes said Saskatchewan will pilot the Maritime province’s collaborative emergency centre program once the details can be worked out.

He toured two facilities while in Nova Scotia in late July and officials from that province will be in Saskatchewan in September to provide more details.

“The beauty of the CECs and primary health care is they can be tailored to the community’s needs,” he said. “Fundamental is keeping emergency care open and taking the stress load off physicians.”

CECs are open 24 hours a day, seven days a week. A primary health-care team staffs the centre during the day.

At night, the centre is staffed by a registered nurse and a paramedic or, as in one Nova Scotia centre, two nurses. A physician oversees the night team from off site.

Weekes said when a patient arrives, the staff assesses the situation and contacts the physician by telephone or other technology.

“This physician does not have to be in the community or even in the health region,” Weekes said. “In Nova Scotia’s situation, the physician is actually in Halifax.”

Depending on the medical condition, the patient could be moved for treatment, treated on site or asked to come back in the morning for a same day or next day appointment with the local physician in a clinic.

Weekes said the main advantages are that patients get emergency care they need and physicians aren’t on call 24-7.

He said Nova Scotia has also found a reduction in the number of people using emergency rooms because they don’t have a family doctor or can’t get an appointment.

“They know they can get an appointment in the clinic on a timely basis,” he said.

The CEC model doesn’t require new facilities, but operates in existing hospitals or integrated facilities.

Weekes said it will be up to the province’s health regions to decide if they want to pilot this approach.

It requires support from patients, communities, health regions, the ministry and physicians if it’s going to work. Several regions have already expressed interest.

“I think the concept is fairly simple,” the minister said. “Implementation and making it work are much more difficult from what the Nova Scotia people have said,” he said.

Since he was appointed minister a couple of months ago, Weekes has visited 15 communities, listening to concerns, and has another 25 on his list.

General themes are emerging: physician recruitment and retention, availability of emergency services, 24-7 on call for doctors, how best to use health-care professionals and new models for health-care delivery.

“Health care and rural health are undergoing transformation, there’s no doubt about it,” Weekes said. “Very often, these different forms of health-care models can help.”

The CEC approach was one recommendation contained in the health-care innovation working group report, led by Saskatchewan premier Brad Wall and Prince Edward Island premier Robert Ghiz, which was presented to all premiers at their recent July meeting.

Weekes said he can see how physician recruitment and retention in rural areas could be improved using the CEC model.

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