How FAST is health care?

This is Stroke Awareness Month. The Heart and Stroke Foundation are running ads to raise awareness to recognize when someone is having a stroke and to act quickly. The campaign acronym is FAST:

F – is the face drooping?

A – can both arms be raised?

S – is speech slurred or jumbled?

Ttime to call 911

The H&SF want the public to know that strokes aren’t just an old person’s problem, they can hit much younger people. We are told it’s important to be vigilante because the stroke victim can’t speak or act for themselves and to act quickly.

Fine. But can your swift action be undone by hospital staff who function on a first-come-first-served versus a triage basis?

Too often in our system assessments are wrong and won’t be revisited for fear of inpuning another professional’s reputation or some staff are just too pig-headed to avert their attention from one case to another. It is surprising how often in an ER situation you encounter people fixated on a type of appointment medicine.

Equally bad are policies which don’t seem to be in the patient’s best interest. Case in point was the December 2009 incident in Middleton, where an 83-year-old woman raced into Soldiers’ Memorial Hospital seeking help for her 81-year-old husband who was having a heart attack across the street from the hospital. No medical staff came to their aid, instead she was told to carry him in herself or call 9-1-1. They wouldn’t even make the call for her.

With the man’s family and community upset and international news media shining a spotlight on the case, Annapolis Valley District Health, which was headed by Janet Knox who now heads the unified Nova Scotia Health Authority, at first defended the policy and then said they would launch a policy review. Six years later I haven’t found anyone who knows the results of the policy review. That’s pertinent because not long ago a man in Halifax collapsed on a hospital walkway. There was debate about who would come to his aid: staff or paramedics.

Compounding the matter is the failure of Capital Health to meet provincial standards for off-loading patients from ambulances. The provincial guideline is for a patient to be off-loaded in 20 minutes. In the fourth quarter of 2010-11 Capital Health was taking an average of 133 minutes (two hours and 13 minutes!) to remove a patient from an ambulance. Capital Health promised then-Minister MacDonald they would improve their performance by 10 percent per quarter to meet provincial targets. Their self-imposed four-year deadline is September 2015.

Now that Nova Scotia has a unified health care system, what is the provincial policy for delivering emergency assistance to people outside of a hospital or clinic building? And do all front-line professionals and facility managers know it?

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