3. Engagement with Nova Scotians

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Working with patients to create a strong foundation for quality surgical care

Dog 9

Krista Wood

Dr. Ellen Crumley has many roles: mother, wife, faculty at Dalhousie University’s Rowe School of Business, and for much of 2016 and 2017, patient.

Over the span of nearly 22 months, the professor was in and out of operating rooms, emergency departments and inpatient units in Halifax, dealing with a breast cancer diagnosis and other issues that resulted in four urgent surgeries. As a surgery patient, she has learned first-hand how important it is to ask questions and be an advocate for the care and support she needs.

It was what Dr. Crumley experienced as a patient in three different hospitals and with three different surgeons – both positive and negative – that led her to join NSHA’s new perioperative (surgical) services quality council. She now volunteers alongside fellow patient representative Robert Zed to offer their insights on improving surgical quality and advocating for patients and their families.

“Patient empowerment is an important issue. Because some patients like me are not ‘obedient’ it can cause tension,” Dr. Crumley said.

“The time patients get with their surgeons can be limited and we need to help patients and their families make the most of this time. Our health care providers need to be open to answering questions and discussing options so that we can make the choices that are best for us. Our choices might not necessarily be what a provider would choose and as patients we need to feel empowered to speak up.”

Having timely access to quality surgical services is important to Nova Scotians. The creation of a new quality council is just one way Nova Scotia Health Authority (NSHA) is working to improve access and ensure that patients have a voice.

In 2017-18, NSHA provided more than 70,000 surgeries, through 17 locations, at a total cost of more than $225 million.

Under the former district health authorities, these surgical sites operated somewhat separately from one another. Different resources, policies, information systems and approaches to care meant that Nova Scotians could experience very different access, supports and services depending on where they received care.

“Patients and their families depend on us and we have a responsibility to ensure we are co-ordinating our precious health care resources to offer them the best possible surgical care and support,” said Dr. Marcy Saxe-Braithwaite, senior director of NSHA’s perioperative (surgical) services team. “We have to be prepared to innovate, to do things in different ways, to benefit our patients.”

In 2017-18, NSHA finalized a new provincial leadership team made up of operational and physician leaders. This team is working with staff and physicians to increase co-ordination and better share resources across the province. They are focused on key priorities, including patient safety initiatives; reducing wait times for surgical services; increasing patient, family and provider engagement; and making more efficient use of operating rooms.

Dr. Eric Howatt, senior medical director of perioperative services, co-leads the provincial program with Dr. Saxe-Braithwaite. He agrees that the work now underway will set the stage for ongoing improvements to surgical services across the province.

“Our teams are passionate about the care we offer,” he said. “More connected teams, along with improved communication and engagement, shared policies and standards of care, improved data and reporting, a greater focus on research and outcomes, and other changes, are supporting our efforts to improve services for Nova Scotians.”

Patient representative Robert Zed has worked professionally with health care leaders as a consultant and believes strongly that efforts underway to improve Perioperative Services must be grounded in the needs of patients.

“The real opportunity for Nova Scotia Health Authority is how they provide safe, seamless, comprehensive and coordinated care and services for the citizens of Nova Scotia,” said Zed. “In the past 18 months alone I have had three surgeries and literally multiple dozens of clinic and follow up visits. I have experienced the complexities, successes and frustrations of the system and the need for caring, open and transparent communication about my scary journey. The moment of truth for any citizen is the relationship between the caregiver and the person when they step over the threshold and enter the journey as a patient.”