Slow ambulances nothing new

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.



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1 Response to Slow ambulances nothing new

  1. Bubbie says:

    The ACE Team, Advocates for the Care of the Elderly have been involved in meetings with Department of Health bureaucrats and elected representative for the better part of fifteen years in an effort to improve the quality of care for the elderly and long-term-care residents, in general. During that time we have seen a Tory Ten Year Long-term Care Plan, which was almost completed when the NDP were elected who, then, canceled the remaining 600 long-term care beds of that plan. This plan was designed to create more long-term care beds that would have greatly reduced long wait times in the ER. The NDP made extensive cuts to long-term care in the remaining years of their mandate without developing any kind of plan, adding to ER wait times and even ER closures. The Liberals were elected with promises of keeping ERs open, but didn’t have a plan for doing this. Instead, what we have seen is a “Code Census” being announced at the QEll Infirmary on a daily basis resulting in longer wait-times, where it cost a man’s life suffering from pancreatic cancer after waiting an agonizing day and a half in the ER hallway waiting to be seen by a doctor.

    During the past year, the ACE Team has been successful in meeting with the DOH on a more regular basis and are in on the ground floor of receiving information concerning a new Continuing Care Plan. On July 27th, 2016 the ACE team presented a brief for what we believe is a solution for better quality care for long-term care residents, particularly, the elderly. During that meeting, acting CEO Carolyn Maxwell suggested we meet on a regular basis saying we could work together and would be instumental in developing a new long-term care plan. It took until July 29th of this year to get another meeting, the government, shared with us an agenda for the begining of the new plan. We presented a second brief and because time was tight did not get a chance to hear their agenda.

    Another meeting was scheduled for Septmber 19, which we had. The DOHW CEO, MJ MacDonald unveild the Continuing Care Plan to us. It is a five year plan leading into a thirty year plan. I asked if the number of years could be reduced to a three year plan which would have been within the life of the present Liberal Government. I pointed out to her that governments tend to make plans longer than their mandate and when a new government comes along the plan is trashed. MJ told me it was not in her power to make the plan shorter or to build anything into the plan that would force another government to continue along the same path. On top of all that the budget that was unveiled was exactly the same as the one presented prior to calling the last election, effectively resulting in another cut on top of the $8 million dollar cut announced prior to the last election. So, it seemes like we are into a spiral of never ending plans that will never come to fruition and at the same time governments will continue to make budget cuts which will be used at a later date to dismantle our Health Care System altogether.

    Never wanting to give up, the ACE Team has another meeting scheduled for November 29 and will continue to plod along in the hope we are making a difference.

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