Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental ScanSecondary care comprises emergency, general medical and surgical, anaesthesia, psychiatric, paediatric,obstetric, and diagnostic services. It will be available to all regions.Tertiary care refers to more specialized diagnostic and treatment services that are provided on referral fromother hospitals or from physicians. Tertiary services are those that cannot be efficiently or safely provided inmost health regions because a large population base is not available to produce the number of cases requiredto sustain competence i.e., neurosurgery, cardio-thoracic surgery, transplant services, specialized medical,obstetric, paediatric, gynaecological and psychiatric services.Quaternary services refer to the most technically demanding level of acute inpatient care, for people withextremely complex or rare medical conditions who require highly specialized care. The demand for service atthis level would be very low; referrals would be made as required, and may be out of province.Applying the Manitoba approach to Nova Scotia with its network of community and regional hospitals, the corephysician services become comprehensive family practice across the province and emergency, general internalmedicine, general surgery, psychiatric, general paediatrics, general obstetrics and general laboratory andradiology (screening, routine diagnostic and imaging, x-ray, ECG) services in community and regional hospitals.The report goes on to identify the key requirements of an effectively integrated province-wide system ofprimary, secondary, tertiary, and quaternary care e.g., patient transport, diagnostic sampling, testing, andresults reporting, etc.8.2.3 OntarioAn Ontario joint policy and planning committee report 17 to the Ontario Ministry of Health defined the coreservice role of small hospitals. Preparatory to their report, they defined small hospitals as those with fewerthan 4,000 inpatient weighted cases per year and divided these hospitals into two groups:−−Very Small: < 1,500 Weighted Cases (62 sites); andSmall: 1,500 to 3,999 Weighted Cases (31 sites).The Ontario report identified the following as core services for the very small hospitals and associatedpopulation centres:ooo−Emergency services:Emergency departments must be prepared to provide care to, or stabilize and transfer, patientsentering via the emergency department− Medicine program with inpatient medical beds;− Physician specialty of General/Family Practice supported by broadly trained Nurses;− Inpatient allied health services, such as:Physiotherapy, Clinical Nutrition, Occupational Therapy, Respiratory Therapy, Speech Pathology andPharmacy; and,Tailored to meet the specific needs of the population being served; and− Diagnostic services, such as:− Laboratory, Ultrasound, General Radiography and Non-invasive Cardiology.The above definition is comparable to the 0-4,999 population centres in the IHA British Columbia definition.17 Ontario MOHLTC, The Core Service Role of Small Hospitals in Ontario Summary Report to The Minister of Health andLong-Term Care From The Ontario Joint Policy and Planning Committee (JPPC) Multi-Site/Small Hospitals Advisory Group,Dec/06.55 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011