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Leading practice client management model improves rehabilitation waitlists for patients across Nova Scotia

Archie Stewart

Lesley Squarey

A new leading practice client management model for Rehabilitation Services is cutting waitlists across Nova Scotia anywhere from one year to just a month.

The Client-Centered Waitlist Management Model, which was recognized as a standard of excellence by the Health Standards Organization (HSO), connects clients with Rehab Services directly through the referral process – allowing clients who are able to start therapy right away, access treatment more efficiently.

“Prior to the change, some sites had up to 100 non-urgent patients waiting for an appointment,” said Angela Stairs, director of rehab services, eastern zone, Nova Scotia Health Authority (NSHA).

“Patients would be referred by a physician, triaged by a physiotherapist and then clerical staff would contact them for an appointment - often several months after the initial referral occurred.”

Stairs and the Rehab Services team were looking for inspiration when they discovered a webinar led by Cathy Hoyles, physiotherapist for Eastern Health, Newfoundland.

“They struggled with a lot of the same inefficiencies. When we saw the results, we got really excited. We knew we could do it and take it to the next level.” Now, clients receive a letter with instructions upon receipt of referral. They are then required to call and book an appointment instead of waiting for a call.

Rehab Services offers the Client Centered Model at the following sites across NSHA:

  • • Straight Richmond Hospital
  • • Saint Martha’s Regional Hospital
  • • Glace Bay Hospital
  • • Cape Breton Regional Hospital
  • • Nova Scotia Rehabilitation and Arthritis Centre
  • • Digby General Hospital
  • • Roseway Hospital
  • • Barrington Community Health Clinic
  • • Aberdeen Hospital
  • • Sutherland Harris Memorial Hospital

Since its implementation two years ago, roughly 40 per cent of clients who were referred and triaged as non-urgent, called Rehab Services for an appointment. The remaining 60 per cent who did not call were surveyed. Results indicated that the most common reason people did not make an appointment was because they sought care elsewhere or did not feel they needed the service. “In the old system these people would have remained on the waitlist when they really didn’t want or need the service,” said Stairs. “Now, those who are in desperate need and have no other options, can access it sooner.”

Natalie Bourque, physiotherapist and manager of Rehab and Respiratory Services in south west nova says the benefits have been felt province wide for clients, clerical and clinical staff.

“Simply put, we’re able to provide better care,” said Bourque.

“Clerical staff are able to schedule clients when they need it and it has boosted morale for our therapists. It’s engaging and clients are more invested.”

The Client Management Model is a flexible, sustainable, person-centered process that encourages clients to be partners in their own recovery. For Stairs, that’s something she sees many areas of healthcare benefiting from – not just Rehab.

“I hope that we can continue to build on what we’ve achieved and that similar services across the NSHA with waitlists are able to adopt it and have it work for them.”