Future Directions
This week we were asked to curate resources on the future of health and health care in Canada. Nova Scotia is in a crisis when it comes to citizen’s ability to access primary care. There is a family physician shortage and a population that consist of aging individuals with chronic conditions. This issue was identified as early as 2008 as is stated in an article by Villeneuve & MacDonald, 2006. They say, “Our province has one of the sickest populations in the country with the second-highest rate of diabetes, some of the highest rates of obesity, and the highest death rates in Canada from cancer and respiratory disease. The article talks about how money will not be the solution but a change in care model. This is the introduction of the Collaborative Care Model. There has been a continued commitment to this model with the announcement this year of funding for more teams. Resources on Collaborative Care Teams below:
Villeneuve & MacDonald, 2006, Toward 2020: Visions for Nursing
Primary Health Care in Canada: Systems in Motion - HUTCHISON - 2011 - The Milbank Quarterly - Wiley Online Library https://onlinelibrary.wiley.com/doi/full/10.1111/j.1468-0009.2011.00628.x#.WrvXK4S0TpY.email
Carol P Herbert. (2005) Changing the culture: Interprofessional education for collaborative patient-centred practice in Canada. Journal of Interprofessional Care 19:sup1, pages 1-4.
Another solution to help with patients receiving timely primary care has been the development of the role of Community Paramedics and Extended Care Paramedics.
Ashton C, C., Duffie D., Millar J. 2017. Conserving Quality of Life through Community Paramedics Healthc Quarterly. 20(2):48-53. http://www.longwoods.com/content/25228
Part of extended Care has been their role in Paramedicine. An article by Carter et al. (2018) tells us that despite 75% of Canadians wishing to die at home, 70% die in a hospital. To address this, Nova Scotia, PEI and NB Emergency Services partnered up with Cancer Nova Scotia and the Canadian Partnership against Cancer and created the program, ‘Paramedics Providing Palliative Care at Home Program’. The aims of the program are:
The aim of the Paramedics Providing Palliative Care at Home Program is to:
• Improve access to palliative care supports at home regardless of time of day or location in Nova Scotia;
• Enhance the palliative and end-of-life experience for patients and their families by “bridging” palliative care supports until the usual care team can take over;
• Avoid/reduce emergency department visits for patients receiving palliative care; and
• Improve paramedic comfort and confidence in supporting patients (and their families) receiving palliative care.
More about the program is found here:
Overall, the trend would be ensuring that the right people are doing the right job and that we are all working together to improve the system.