The news today is slow off-loading of ambulance patients at major hospitals in Halifax. The provincial requirement is for patients delivered to hospital in an ambulance be off-loaded within 20 minutes 90 percent of the time.
Halifax’s failure to meet the requirement is nothing new. The last time we learned of this failure in delivery of care was in 2010-2011. A then weak or disinterested health minister allowed the Capital Health Authority to set their time-line for improving performance. It was a five-year to-hell-with-patient-pain-and–suffering solution that also ignored potential catastrophic consequences of delaying ambulances in hospital parking lanes.
This is what I wrote in April 26, 2012:
The province has a target to off-load patients from ambulances in 20 minutes 90% of the time. Capital Health is nowhere near meeting provincial targets. In their fourth quarter report for 2010-2011 they admitted to off-loading patients in 133 minutes. That was up from the 114 minutes it took in the previous quarter. Capital Health promised to improve that by 10% per quarter. At 10% per quarter it will take them until September 2016 to achieve the provincial health department’s targets. That’s not performance. And what if they don’t achieve their own target? Aside from the pain and suffering and inconvenience to patients, what is the impact on executives collecting six-figure incomes? I don’t understand why the Minister and the Premier think it’s acceptable for this health authority to flaunt the regulations this way. Allowing public servants to re-set loose, self-regulating, multi-year soft targets is one more example that this administrative structure is not operating in the public interest.
I brought up slow off-loading on:
January 4, 2012:
July 30, 2014:
February 7, 2015:
March 16, 2015:
June 12, 2015:
and on November 6, 2016 I wrote this:
Another example of this preferred five-to-seven health care timeline arose in the fourth quarter of fiscal 2010-2011. It was a different administration, but it was discovered that Capital Health took up to 133 minutes (two hours +) to offload a patient from an ambulance instead of the provincial criteria to complete this in 20 minutes. Capital Health told the then NDP government they would improve by 10 percent per quarter to achieve the provincial requirement. For some unexplained reason, then Health Minister Maureen MacDonald allowed then Capital Health CEO Chris Powers to dictate to the ministry. Doing the math, this incremental quarterly change meant Capital Health/NSHA wouldn’t meet the provincial requirement for five years. The health authority’s self-imposed deadline was September 2016. In those five years, people in dire enough condition to be delivered to hospital in an ambulance could be left for hours in an ambulance without being seen by hospital staff. Allowing the authority to determine what would happen is insensitive, unresponsive and arrogant.
It is clear that Nova Scotia’s health executives rely on a short public and political memory to get away with continued failure to deliver care. It is time for the Department of Health to dictate to the Nova Scotia Health Authority a time-frame for fixing the problem. And it has to be a short time frame because obviously anything else is merely cover for the executives and not a serious solution.