Stellarton Mayor Joe Gennoe signs a proclamation for VON Week, which takes place May 15 to 21. The VON, working with the Nova Scotia Health Authority, the Nova Scotia Department of Health and Wellness and the NSGEU, has eliminated wait lists for home support care in Pictou County.
Now, that wait list has been eliminated. As of March 10, the list – which at one point reached 4,000 hours per month and had been in place for more than two years – was reduced to zero.
“Eliminating and reducing the list is all about finding efficiencies in how we do the work,” said Carol Curley, executive director of the Victorian Order of Nurses in Pictou County, which holds the local contract to provide home care services for the Nova Scotia Health Authority.
She said while achieving success in getting rid of the wait list, “there’s still lots of work to be done.”
Home care consists of two parts – nursing care and home support. Curley said no waiting list existed for nursing care, which includes IV therapy, wound care and assistance with medications. Home support consists of any non-clinical services such as bathing, helping with meals and light housekeeping, in order to keep people in their own homes.
While it may seem like just hiring more staff would take care of the problem, it’s not that simple, said Susan Stevens, the senior director for continuing care for the Nova Scotia Health Authority.
“Wait lists are complicated,” she said. “People think we just need to hire more workers – that’s part of the equation – you have to have enough workers to do the work.”
But she said such things as scheduling and conditions in collective agreements also have an impact.
“It’s not just the number of staff, but how we use them and schedule them,” said Curley, adding that the hours of care required frequently fluctuates.
Stevens said the NSHA has been working with the Department of Health and Wellness, the VON and the NSGEU since last summer to tackle the wait lists in home support. “And one of the outcomes is establishing a pilot project in Pictou County… but at the same time we’ve been working with the VON in Pictou County all along – making adjustments in their approach and our approach,” she said.
Pictou County and the Annapolis Valley were two areas of the province identified as having the largest wait lists. Curley said the three-month pilot officially began in April, but the wait list had been eliminated before it started.
“It started with Pictou County and now in the Valley. We’re taking the lessons we learned in Pictou and applying them there. We really felt we needed to start working right away,” said Stevens.
She said the pilot project will build on the success in Pictou County, measuring what worked and what didn’t, to establish a formal framework that can be used in other parts of the province.
“Our mandate at the end is to recommend best practices that can be shared broadly. We’ve already identified some that are being incorporated as part of the pilot project. It’s exciting for us – we’re leading the way in home support across the province,” said Curley.
She said some of the success can be attributed to improving how staff are assigned, and better planning for their visits, including clustering visits together to reduce distance and travel time. “The more time they spend in the car, the less time they spend with clients,” she said. “It’s having the right people working at the right time in the right place.”
Other strategies include improved communication, reassessing clients regularly, and looking at creative ways to provide service. For example, where appropriate when providing respite service, those in need of care could attend an adult day program that can accommodate a larger number of people. “It can provide for 10 at a time versus one on one in the home,” said Curley.
And instead of having a home support worker cooking meals for one client, Meals on Wheels can provide hot meals to a greater number of people.
Another of the main outcomes involves cancelled visits. Stevens said when client cancels a visit without enough notice, that hour of service is lost. “Nobody benefits from it,” she said.
To combat this, a new information package was developed, and NSHA care co-ordinators educate clients and their families about the importance of giving 24 hours of notice if a visit needs to be cancelled. This way, the worker can be rescheduled. “Somebody else can benefit from getting the care they need,” said Stevens.
Facts and figures:
In Pictou County:
The VON provided roughly 145,000 hours of home support last year up until the end of March. (Home support is tracked by the hour.)
On average, this is 12,000 hours per month.
The VON currently has slightly fewer than 500 home support clients.
Home support services are provided by about 200 front-line staff, 30 support staff and 70 volunteers (for such things as Meals on Wheels, transportation, and adult day programs support) for the VON.
Across the province (as of April 15):
503 people are waiting for home support
Of those, 191 are getting some of the services they require, while 312 aren’t getting any service at all.
Of the 3,881 hours of care needed, the bulk of that is in Colchester County, with 91 people waiting for service requiring 1,776 hours of care.
In the Annapolis Valley, 159 people are on the waiting list for 713 hours of care.
Of the 3,881 hours, 1,270 of those hours account for people who are getting part of the service they require, while 2,066 are people who aren’t getting any service.
