New Approach to Health Planning Introduced

A new approach to health planning was introduced today with the release of a report on Nova Scotia's acute-care services by the Department of Health?s Clinical Services Steering Committee.

"Today is an important day in the history of Nova Scotia?s health system,? said Health Minister Jamie Muir. ?For the very first time we will be able to make better health care decisions based on solid evidence. Good evidence supports good decisions. The end result will be better health care for Nova Scotians."

The Clinical Services Steering Committee was established to examine all aspects of Nova Scotia?s acute-care system, including distribution of hospital services and the demands and trends in providing acute health services. The minister accepted the report from the committee after a briefing on specific findings and observations.

The committee included individuals who work directly in the health-care field, with representation from all regions of the province. Committee members were Chair Dr. David Rippey, Northern Region; Dr. Brendan Carr, QEII; John Malcom, Cape Breton Health Care Complex; Marguerite Rowe, Western Region; and representatives from the Department of Health.

"The principle behind the approach is straightforward," said Dr. David Rippey, committee chair. "It involves assembling evidence so health planners can make better decisions that will help address the unique needs of individual communities. Increasing the understanding about current usage patterns and practices, along with the trends in the treatment of acutely ill patients, will allow the right choices to be made," he said.

The committee's report is intended as a tool to assist district health authorities with health planning. The authorities will discuss the information with local stakeholders to determine how it can be used for planning and decision-making in their communities.

"This approach will help district health authorities match health resources to community needs for today and tomorrow," said the minister. "The report includes valuable information for health- care decision makers in our province."

Some key findings were:

• Nova Scotians use inpatient hospital beds more often than most other Canadians, but less often than other Atlantic Canadians.

• Nearly 30 per cent of hospital patient days were for reasons other than active acute care. Nineteen per cent of patient days were being used by long-stay patients, while 10 per cent were days that could be reduced through improved scheduling and process improvements.

• Hospitals in Nova Scotia vary widely in the volume of services they deliver, new approach to health planning was introduced today and there were differences in utilization patterns depending on where you live in Nova Scotia.

• All Nova Scotians currently receive the majority of their acute hospital care in their own districts, but there are opportunities to increase the amount delivered closer to home.

• Income is the major socio-economic factor found to directly influence acute hospital bed use.

• The average length of stay in Nova Scotia hospitals is 3.6 days, compared with Ontario at 3.4 days and British Columbia at 3.2 days.

Based on these findings, the committee developed guidelines for decision-making in district health authorities. These included:

• Categorizing hospitals into five key groupings according to demand for care and complexity of services. Each district would have a district hospital supported by community hospitals depending on the local circumstances.

• Outlining the set of services that each hospital category should provide.

• Setting ideal benchmarks for numbers of physicians to maintain in-hospital acute programs and services.

• Exploring ways to alleviate the bottleneck of long-stay patients in hospitals by providing more treatment options.

• Outlining four key principles for decision-making by all health partners, namely sustainability, quality, access and affordability.

"We are determined to create a reliable, dependable health system in this province," said the minister. "The work of this committee is an important step toward achieving that goal. It has never been more important than now to make decisions based on good evidence considering the nation-wide competition for health-care providers and scarce financial resources," he said.

Future phases of the clinical services review will examine continuing care, primary care and emergency health services. Together, they will result in a better understanding of the overall health system in Nova Scotia and will provide the information base to make consistently solid decisions.

NOTE TO EDITORS: The Clinical Services Steering Committee report can be found at www.gov.ns.ca/health/ .