The NSHA is busy, try again

Dr. David Zitner wrote an op ed in The Chronicle Herald titled NSHA seems to specialize in inconveniencing patients. Zitner is bang on.

Zitner wrote, “If there’s any way to inconvenience patients and embrace antiquated methods, the Nova Scotia Health Authority will find it.

“Ask the sick patients who are trying to arrange appointments with specialists, or for imaging tests or for blood work.

“Most enterprises try to encourage and support increased consumer access to worthwhile services. Not the Nova Scotia Health Authority!

“Try to book an appointment for an X-ray or blood tests. In the past, you were given a requisition. For most tests, your doctor’s office made an appointment, or you just marched off to the hospital or laboratory, waited for a long or short time, and then had the test.

“Now, in the Internet age, you’re given a phone number to call to book blood tests or imaging investigations.” And the NSHA’s phone system makes it a herculean effort to reach them.

The NSHA’s senior director pathology and laboratory medicine, Shauna Thompson, told the CBC on September 14 that the phone system was “incredibly frustrating”. She also said, “our number one priority is to improve the patient experience…” She ended her interview by saying an on-line booking option is coming … by end of year!

We are eight months into this pandemic, how is that not enough time for the NSHA to have identified the problem and resolved it? And even after eight months the NSHA needs three or four more months to offer a better way to contact them. That’s absurd.

The NSHA’s cavalier attitude is amplified by a June 24th, 2020 post to their website. The post NSHA working to address issues with blood collection appointment telephone booking process says “Nova Scotia Health Authority (NSHA) is working to address issues and delays people are currently experiencing when they call to book a blood collection appointment.

“We know patients are having difficulty getting through our phone lines to make an appointment for blood collection,” said Shauna Thompson, NSHA Senior Director, Pathology and Laboratory Medicine. “This is very frustrating for callers. We sincerely want to apologize for these current delays, and ask for your patience while we work to address the issue, and improve the appointment booking service.”

Make comforting sounds and hope people don’t pay attention to their lack of action is how the NSHA operates.

In the three months since the NSHA posted their empathetic message what have they done? How is it that a vital service like the health authority seems to use an archaic phone system? And why can’t their provider do an immediate upgrade? How is there not an off-the-shelf phone solution?

The NSHA is always “working on”, “looking into”, “investigating” solutions, but we see precious little in the way of results. If the NSHA can’t find a fix for their phone system first in four months, then after eight months what else can’t they do?

Unbelievably the NSHA’s phone system doesn’t always accept you into a call-waiting queue. With the NSHA you can get a busy signal or a message to call again later!

My first-hand experience attempting to book an appointment shows patients need a level of tenacity that may be beyond most people’s patience.

On August 18 I had to book an appointment to have blood drawn at Valley Regional Hospital. On my third call I started to write down what was happening:

Calls 1 & 2 – busy signal

Calls 3 & 4 – message to try later

Call 5 – busy signal

Call 6 – message to try later

Calls 7, 8, 9, 10, 11 – busy signals

Calls 12, 13, 14, 15, 16, 17, 18 – message to try later

Call 19 – busy signal

Call 20 – message to try later

Calls 21, 22 – busy signal

Call 23 – message to try later

Calls 24, 25 – busy signal

Calls 26, 27 – message to call later

Call 28 – managed to get into a phone queue. It took 1 hour, 29 minutes before I spoke with a person who booked an appointment for August 31. In total I was on the phone for two hours and 11 minutes.

And then on August 31 when I arrived at VRH I was told they had no record of the appointment! And couldn’t fit me in!! I eventually got an appointment for September 11! That’s 25 days to have a blood test. How many people can become seriously ill in such delays?

Since the Nova Scotia Health Authority can’t handle the call volumes, the solution is block booking appointments. Rather than call the NSHA, I suggest people call your MLA’s office and have them create lists of constituents needing appointments. MLAs and their staff could make one or two calls a day on behalf of dozens of constituents needing medical appointments then confirm details with constituents.

That would reduce call volume and ease frustrations. And provide a further back up for lost appointments like mine.

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6 Responses to The NSHA is busy, try again

  1. peter l loveridge says:

    The NSHA employs 2700 administrators at more than $100k/year. Perhaps some of them might be capable of answering the phone. But far simpler, if the present administrators can’t actually administer the service, get rid of them and find someone who can. My local commercial fishing suppliers (I am in there 2 or 3 times a month) is about as busy as the Yarmouth hospital lab. They restrict the number of customers at any one time to 15 and have social distancing in the store, but you can just turn up, and the transactions are more complicated than just taking blood.

  2. buddyboy546 says:

    I wrote to the Premier about this at the end of August. Here is my letter, similar to your own experience, and the ensuing reply.

    “Dear Premier:

    I write with words of concern about something I find troubling. We are over six months into adjusting to the Covid situation so plenty of time for the Nova Scotia Government to have made adjustments and iron out initial inefficiencies.

    Today my wife M telephoned to make an appointment at Queens General Hospital to have blood tests done for me. She waited on the phone to speak to the receptionist for a full 25 minutes. When she finally received an answer and mentioned the wait time she was told wait times on the phone can be as long as one hour. M commented she, M, should agitate for more staff and was told “Oh, no, there is no shortage of staff.”

    The earliest appointment available for a blood test was September 17, two and a half weeks later! The clerk said the area she was servicing was from Lunenburg to Wolfville to Shelburne. Both the routine one hour waits and two and a half weeks lead time are unacceptable. Somebody has made the decision that Covid makes inefficiency acceptable. It does not.

    I subsequently learned that the government is considering making blood test appointments available on line. As an option that would be good (if it worked) but keep in mind that blood testing is used disproportionately by old people, hardly a group that can be expected to benefit much from online service. Is anyone holding the health powers that be accountable in such matters? With our legislature and committees shut down, it is evident that our highly paid leaders, including yourself, are being shielded from accountability.

    Yours truly,

    Here is the response:

    Dear Mr. :

    Thank you for your email dated August 31, 2020, about access to the Nova Scotia Health Authority’s (NSHA) blood collection service. As Senior Executive Director responsible for Health Promotion/Mental Health & Addictions & Acute Care in Nova Scotia, the Premier has asked me to respond on his behalf.

    I empathize with your wife’s experience that you have described in your letter and acknowledge your concerns. I also understand the public’s frustration with the current process for booking blood collection appointments and how difficult it can be to have to wait for these services.

    The NSHA realizes that increased demand has created a backlog in the system and that patients are frustrated, having to call multiple times to get through to book an appointment and then waiting longer than usual for the blood test itself. The NSHA is working hard to address the issue and appreciates your patience as they work to make improvements to the booking service. A long-term solution is being developed which will bring significant improvements. In the short term, the service is working on adding more phone lines and implementing longer hours, including weekend hours, to take calls while they are working on a more permanent fix. The NSHA is aware of the accessibility issues of an online booking service, and the phone service will continue to be in place for those who would prefer to book an appointment using that method.

    If this occurs again for an urgent need, you may contact your family physician’s office as they may be able to schedule the appointment more quickly on your behalf. We also understand that the phone lines are typically not as busy during evening hours.

    Thank you for sharing your concerns.

    Sincerely,

    Vanessa Chouinard

    Senior Executive Director

    Health Promotion/Mental Health & Addictions & Acute Care

    Department of Health and Wellness

    • After I complained about my lost appointment I was called by someone at the NSHA. She told me that they are booking fewer appointments as a way to reduce COVID-19 exposure. It’s an interesting position to take since it implies the NSHA believes we suddenly have less need than before the pandemic.

      As for the suggestion to call your doctor to make the appointment, good luck. My doctor’s office phone is constantly busy and it doesn’t accept voicemail.

      If we inconvenience enough members of the government someone in the NSHA might get off their ass and do something.

  3. A regular reader says:

    It’s somewhat unfortunate that the NSHA blames the “phone lines” for this debacle. Telephone systems are only as good as the number of available call takers. Adding additional lines when there are inadequate staff to handle the incoming volume is somewhat like putting your finger in the proverbial dyke.

    Most modern systems today are IP based and can be rapidly reconfigured to handle additional lines. That being said, in a scenario where inbound traffic reaches such high volume as 49,000 calls in one week (!!), no system is designed to function without busy signals. Callers get bumped out of the queue, depending on the system configuration, when the queue is full.

    Modern call centre technology will permit you to “fail over” to another available site, and this disaster recovery scenario (if properly designed), can be configured to several back up teams or locations.

    At one time, Telcos would maintain very close relationships with their clients and prepare for such eventualities. Since deregulation, and in an environment where vendors are typically selected based on the lowest bid, much of that support and expertise has been lost. In addition, as many businesses, including some government offices, choose to purchase, run and maintain their own systems, you end up with organizations dealing with infrastructure that is far outside the realm of their core competencies, and they have little to no expertise to fall back on. At the end of the day, you need people to handle high call volumes, or you need multiple options for access. Migrating to an online solution does not guarantee a faster response, it just means the patients will not know how long it will be before they have their appointment.

  4. ausca says:

    Disgraceful. It’s said that justice delayed it justice denied. Why would that not also apply to public health as well?

    I’ve also noticed that people I know who have consulted their family doctor over various issues seem to be met with something resembling indifference rather than any evident determination to resolve the issue. These are cases I know about.

    The senior gentleman’s painful legs has been considered rather a mystery for a year now with no clear diagnosis. His repeated efforts to get something done have been only marginally successful. He is barely able to walk, has put on a great deal of weight and has fallen several times.

    My daughter was told by a duty doctor that the lump in the painful wrist was “just her anatomy” although her other wrist had no bump. An Xray showed nothing conclusive, Eventually she consulted a physiotherapist who said that her wrist had been dislocated for around 4 months! Her family doctor explained this by suggesting her wrist had likely been sublexed rather than dislocated, which is why it was missed on imaging.

    My father-in-law’s throat pain/trouble breathing was assumed to be related to his existing COPD but various pain killers and puffers prescribed that proved useless. After 6 months the doctor arranged to have the fellow’s throat scoped, only to find he had an aggressively growing T4 tumour on his oesophagus. I suspect the family clinic felt a certain amount of guilt because they referred him to an oncologist within 3 days. There he was offered a choice of radio/chemo, chemo only or laryngectomy. He chose radio/chemotherapy combination. Apparently nobody mentioned the radiation would also destroy his epiglottis and he consequently never ate again for the last 2 years of his life. The aroma of next-door BBQ would drive him crazy and he had to close the windows. When the pain eventually became worse he was prescribed a narcotic which caused him to vomit and the missing epiglottis allowed that into the lungs which immediately inflamed into pneumonia. He was dead 2 days later. He had served Canada for 25 years in the Navy and when he needed medical help, this was how he was treated.

    Stories like this do little to inspire confidence in Nova Scotia’s public health.

  5. peter loveridge says:

    as a rural doc JUST able to cope with the increased workload due to Covid, the response from the NSHA about family docs makes me want to pick up my musket. What they didn’t say was, yes, family doc calls for urgent test, fine. But what they don’t say is that the FD will then be expected to call the patient with the appointment. THEY ARE JUST TOO DAMNED LAZY TO CALL THE PATIENT WITH THE APPOINTMENT. We cannot cope with more telephone calls, we are at our wit’s end with what we are doing all ready

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