1. Person-Centred, High-Quality, Safe and Sustainable Health and Wellness for Nova Scotians

Return to Home page

Choosing Home First

Dog 9

Many Nova Scotians want to live at home as long as possible. We are working hard to make this happen for more people across the province.

Working to improve wait lists for long-term care, home support

Over the past three years, wait times for long-term care have decreased by 50 per cent. This drastic drop is due to changes in how we work with individuals and families. We explore all options available to support care at home safely for as long as possible before pursuing long term care.

Over the past two years we have reduced the number of people waiting for home support services by 59 per cent (254 people in March 2018 from 616 people in April 2016). We have also reduced the number of hours of care on the waitlist by 73 per cent over this same period.

While we are making good progress we have more work to do to eliminate the current waitlist. As of March 31, 2018 we had 254 people waiting for 1,272 hours of care. How we authorize and organize care is an important factor in reducing the waitlist, as is our responsiveness to service changes. A major contributor to waitlists is a lack of continuing care assistants. We will be working with DHW and home care agencies on a provincial recruitment and retention strategy in 2018-19. And we will continue to work within NSHA and with our partner home support agencies to prioritize high-risk and vulnerable individuals to ensure they receive the care they need in a timely way.

Using best practice to support appropriate placement to long-term care

The team at Valley Regional Hospital has implemented a Home First Transition Team (HFTT). The HFTT is part of a redesigned Home First approach at the hospital to ensure more patients are discharged home with home care and only patients who cannot be supported at home are discharged to nursing homes.

Provincially 60 per cent of admissions to long term care are people coming from their homes. Only 40 per cent of nursing home admissions are people coming from hospital. Our goal was to reach 65 per cent of placements from the community and 35 per cent from hospitals, by March 31, 2018.

Through our efforts, we achieved the following successes:

  • • The number of people on the long term care waitlist in the area has decreased by 25 per cent over past year.
  • • The number of people waiting for long term care placement from hospital in the Valley area has decreased by 31 per cent.
  • • The number of ready-for-discharge days at Valley Regional Hospital attributed to alternative level of care has decreased 10 per cent.
  • • The number of referrals to Seniors LINCS increased by almost 22 per cent. SENIORS LINCS is a multidisciplinary team at Valley Regional Hospital who support seniors through occupational therapy, physical therapy and other services to live independently at home.

Valley Regional Hospital is the site of our EXTRA fellowship through the Canadian Foundation for Healthcare Improvement’s executive training program. EXTRA helps health organizations across the country tackle an existing priority and build their capacity to make ongoing change, accelerating health system improvements.

Measuring performance of home support providers

The Department of Health & Wellness (DHW) and NSHA amended all existing contracts this year implementing new reporting requirements and nine key performance indicators (KPIs). We have also implemented a new performance monitoring committee and process to receive, review and report on agency performance designed to improve both client care and experience. These new requirements are a further step toward new performance-based contracts planned for 2019-20 to help improve quality of care by creating clear expectations and mechanisms for accountability, while obtaining reliable data and reporting to inform decision making. This helps to ensure that high-quality services are available consistently across the province now and into the future.

Conducting research to inform home care

This year a team from Nova Scotia and Manitoba were awarded more than $860,000 from the Canadian Institutes of Health Research (CIHR) for a new research project. This project, titled “How Approaches to Care Shape Pathways of Older Adult Homecare Clients,” is co-led by Dr. Janice Keefe from Mount Saint Vincent University and Susan Stevens, Senior Director, Continuing Care, NSHA in partnership with the University of Manitoba, Dalhousie University, Saint Mary’s University, the Winnipeg Regional Health Authority and other stakeholders. The goal of the project is to better understand how policy, practice and decision-making shape clients’ journeys through the homecare system to inform how we become more person- and family-centred in our approaches to care.

NSHA and MSVU were awarded one of 46 Health System Research Fellowships across Canada through a new program developed by the Canadian Institutes of Health Research for Health Services and Policy Research and the Canadian Health Services and Policy Research Alliance. The Health System Impact Fellowship and Training Modernization Start-Up Grants programs give PhD researchers experiential learning opportunities in health care organizations where they will bring new ideas and innovative approaches to tackle the complex challenges these organizations are facing. We were pleased to welcome Dr. Katie Aubrecht, post-doctoral fellow, adjunct professor and researcher at MSVU, to Continuing Care. Dr. Aubrecht will work with us over the next two years to create and apply new knowledge focused on improving person-centred dementia care for older adults in Nova Scotia.

These are just two examples of important research underway within Continuing Care.