May 30 - Physicain Information Update

May 30, 2024

Three New Canadian Certified Physician Leadership Executives

This past weekend I had the privilege of attending the Canadian Conference on Physician Leadership in Montreal. This is an annual event offered by the Canadian Society of Physician Leaders, a national body to promote education and advocacy for physician leadership.

The theme was Shifting the Paradigm which inspires us as physician leaders to shift the conversation from addressing the symptoms of a health system in crisis to focusing on how to drive fundamental transformation that has lasting impact.

The energy of bringing physicians together in their efforts to build leadership competency is very infectious. I reflect on this role often as Nova Scotia is working hard to drive system transformation, accountability, and adopt Operational Excellence. We have more than 190 physician leaders in co-leadership with their operational counterparts to ensure the physician experience and voices are represented at the decision-making tables across our organization and across our province. As a coach, I know the difference our Physician Leadership Development Team makes in helping develop our leaders and I'm proud that our team is leading this work in alignment with our national leadership organizations.

During this year's conference, three dedicated Nova Scotia Health physician leaders (Drs. Rob Green, Christy Bussey, and Heather Johnson) received their Canadian Certified Physician Executive (CCPE) credential. Also, congratulations to our Nova Scotia IWK colleague Dr. Katrina Hurley. This credential recognizes and advances physician leadership and excellence through a national, peer-generated, standards-based assessment process. It is based on the tenets of the LEADS in a Caring Environment capabilities framework. Obtaining this credential shows Nova Scotia physicians that we are serious about providing excellent physician leadership and willing to put in the work to raise the bar across our organization to a national standard.

"Congratulations Nova Scotia Health — it is a designation that recognizes true physician leadership." ~ Carol Rochefort Retired Executive Director, Canadian Society of Physician Leaders

Those who earn the credential have demonstrated that they have the leadership capabilities, knowledge and skills needed to succeed ― and to direct, influence and orchestrate change in Canada's complex health care system. There are two ways to achieve the credential: the Academic route and the Practice eligibility route.

I would encourage all of our physician leaders to consider obtaining this designation. Other Nova Scotia Health CCPEs and I are ready and willing to help you achieve this your certification. To learn more about the program, visit: https://ccpecredential.ca/. If you have any questions about this program, please reply to this newsletter.

Physiotherapists can now order Diagnostic Imaging

Physiotherapists licensed to practice in Nova Scotia now have the option to initiate the onboarding process to request general radiographs (x-rays) related to a patient’s clinical visit. Requesting x-rays is a part of a physiotherapist’s scope of practice.

Until now, only physiotherapists in Nova Scotia Health and IWK Health who had referral for x-ray within their scope of employment, had this ability.

Learn more: Memo, Frequently Asked Questions. 

Chlamydia Case Management - Central Zone

~A Message from Public Health

Public Health is amending its approach to chlamydia case management in Northern, Western and Eastern Zones. In order to balance numerous priorities and manage limited resources, Public Health is moving to a prioritized approach to chlamydia case management in these zones. This approach has been in operation in Central Zone (CZ) for several years and so Public Health and clinician case management of chlamydia will not change in CZ. Nevertheless, we would like to take this opportunity to remind you of our approach.

Public Health endeavours to follow up on chlamydia cases that meet any of the following criteria:

• Individuals < 12 years old (highest priority)
• Ophthalmic chlamydia infection (highest priority)
• Individuals 12-15 years old
• Partner pregnant or under age of 16
• Individual has no treatment and/or unaware of diagnosis (e.g., cannot afford medication or provider cannot reach individual)
• Individual is pregnant
• Individual co-infected with another STBBI
• Lymphogranuloma venereum (LGV)
• Re-infection

While Public Health receives notification from the laboratory whenever a specimen tests positive for chlamydia, we will not necessarily be aware of all cases meeting one or more of the above criteria (for example, pregnancy) unless we are explicitly so notified. Therefore, if you diagnose or treat a patient with chlamydia who meets one or more of the above criteria, we would like to remind you to please inform us by either contacting us directly or completing the Chlamydia Report Form.

We are grateful to you, our clinical colleagues, for the proactive management you have undertaken to treat and prevent transmission of chlamydia following diagnosis. We would ask you to continue to follow guidance for chlamydia case management from the Canadian Guidelines on Sexually Transmitted Infections and the Nova Scotia Communicable Disease Manual.

In particular, patients should be advised that they should generally notify all sexual partners within the 60 days preceding symptom onset or date of specimen collection (if case asymptomatic) to see a medical practitioner for both testing and treatment (regardless of test results). Note: contact tracing may be indicated beyond this 60-day period and/or involve individuals that are not sexual partners – please see the Nova Scotia Communicable Disease Manual link above for details.

While Public Health cannot at this time undertake contact tracing/case management for all chlamydia case notifications, we continue to be available to assist any practitioner requesting our help with contact tracing or other matters pertinent to the Public Health case management of chlamydia.

Examples of situations in which Public Health can assist chlamydia case management include funding treatment for those who cannot afford it and informing contacts for those unable or unwilling to do this themselves. If you require our assistance, please contact us directly or complete and submit the Chlamydia Report Form to the Public Health office below.

In the absence of an individual meeting any of the aforementioned criteria or a request for our assistance, you are not required to notify Public Health of a chlamydia diagnosis or submit the attached form.

Contact information for Central Zone Public Health: Phone: 902-481-5800, Fax: 902-481-5889

Updated CZ Chlamydia Report Form

Halifax Infirmary Inpatient Addiction Medicine Consult Service Quarterly Update  

We would like to share a quarterly update on the Inpatient Addiction Medicine Consult Service (IAMCS) that is located at the Halifax Infirmary, site of the QEII Health Sciences Centre.

Since its launch in September 2023, this pioneering service provides vital support for patients with substance use concerns, offering specialized advice, knowledge sharing and assistance to physicians and house staff working within Halifax Infirmary inpatient units and emergency department.

Led by a dedicated team of addiction medicine specialists, including physicians, nurses, social workers, and peer support workers, the service ensures comprehensive, multidisciplinary care for people who require hospital care who also have serious addictive disorders, or are experiencing other harms related to substance use and consent to the IAMCS team becoming involved.

IAMCS supported 145 unique patients from September 15, 2023, to March 31, 2024, with the team following these patients throughout their hospital stay. We are happy to share that 48 QEII healthcare providers completed a survey on their experience with IAMCS, highlighting the positive impact and effectiveness of the service, including gaining knowledge and skills on treating patients who use substances, and how they intend to implement it into their daily practice.

As a reminder, the service operates Monday to Friday, from 8 a.m. to 5 p.m., where physicians and their house staff can call QEII Locating and ask to be connected to the Inpatient Addiction Medicine Consult Service. The service is currently only operating at the Halifax Infirmary. IAMCS provides timely access for physicians seeking support, ensuring continuity of care and responsiveness to patient needs. Additionally, it fosters professional development by providing mentorship and learning opportunities for healthcare professionals, contributing to a compassionate, evidence-informed care environment.

We would also like to remind physicians and house staff, we have a telephone-based Addiction Medicine Consult Service that is available province-wide that provides verbal evidence-informed advice to community pharmacists as well as physicians and nurse practitioners working in mental health and addictions (including Correctional Health Services), primary care, emergency departments, long term care, and acute care in Nova Scotia. This service is available Monday to Friday from 8:30 a.m. to 5 p.m. by calling 1-855-970-0234. Messages received outside of these hours are returned the next day of service.

Province Opens Sensor-Based Glucose Monitoring Program

Starting Monday, June 3, eligible Nova Scotians living with diabetes can apply for funding to cover the cost of sensor-based glucose monitoring supplies.

“People living with diabetes shouldn’t have to bear the cost of equipment and supplies while trying to manage a condition that can be life-changing,” said Health and Wellness Minister Michelle Thompson. “The new program will help more people afford the equipment and supplies they need, to better manage their care.”

The Sensor-based Glucose Monitoring Program is open to Nova Scotians with Type 1 or Type 2 diabetes who meet specific criteria, including needing multiple daily injections of insulin.

The program is income-based, with no deductible for people with an annual household income less than $60,000. People with a household income between $60,000 and $150,000 pay a deductible between $500 and $1,000.

Coverage for sensor-based glucose monitoring supplies will also be available under existing pharmacare programs starting next week.

Patients can choose the program – pharmacare or the new program – that best suits their individual or financial circumstances. In either case, patients with private insurance must maximize that coverage first.

More information about the new program and how to apply is available at: https://beta.novascotia.ca/register-sensor-based-glucose-monitoring-program

OPOR Spotlight Series: Subject Matter Experts

The One Person One Record Clinical Information System (OPOR-CIS) represents the most significant, transformative change to healthcare delivery ever experienced in our province.

One of the many important aspects in the development of the CIS is that, while following the Cerner Canadian Reference Model as a guide, the new system is being designed by Nova Scotians, for Nova Scotians.

Subject Matter Experts (SMEs) participate in Design Workshops where they lend their expertise to making design decisions for the new OPOR-CIS. There is a mix of clinical and non-clinical healthcare workers who have given their time to ensure the system meets the needs of physicians, providers, employees, and patients across the province.

We are excited to continue our new series featuring interviews with some of the hundreds of SMEs from different care areas and work streams.

Meet Dr. Angela Giacomantonio (IWK Health) by clicking here.

One Person One Record (OPOR): Did You Know?

Did you know the OPOR-CIS will integrate Clinical Decision Support into electronic medical records?

Clinical Decision Support (CDS) is an evidence-based best practice supported by functionality within a Clinical Information System (CIS). The OPOR-CIS will integrate CDS into electronic medical records, enhancing patient safety, and improving the quality, and efficiency of healthcare delivery.

When providers place orders through Computerized Provider Order Entry (CPOE), such as medication orders, laboratory tests, and procedures, prompts, reminders, and alerts will be enabled based on patient data.

For example, if there is a drug interaction with another medication or condition, the provider will be alerted before completing the order. When care is being delivered, for example a medication is being administered by nursing staff, CDS will prompt an early administration warning alert if the timing isn’t correct.

To learn more about the OPOR-CIS and CDS, read the OPOR May Monthly Update or visit the OPOR website at opor.nshealth.ca

Dr. Mary-Lynn Watson Appointed President of College of Physicians and Surgeons for 2024-26

Dr. Mary-Lynn Watson has been appointed President of the College of Physicians and Surgeons for the 2024–2026 term. Dr. Watson has been involved in the work of the College for a number of years serving on its committees including the Professional Standards, Nominating and Finance.

Dr. Watson is an Associate Professor of Emergency Medicine at Dalhousie University. She is originally from New Brunswick but came to Dalhousie to do her undergraduate degree, went on to graduate from Dalhousie Medical School and decided to make Halifax her home.

She started practicing Emergency Medicine at the old Halifax Infirmary and Victoria General Hospitals and now practices at the Emergency Department of the QEII Health Sciences Centre (QEIIHSC), Halifax Infirmary site. At that time, she also had a family practice but left to focus her career on emergency medicine.

Dr. Watson is presently the Medical Director for Quality and Safety at the QEIIHSC Emergency Department. She is active on many committees in the Department, as well as at Nova Scotia Health, the Medical School, and nationally. She serves on the Progress and Promotion Committee at the Medical School as well as committees at the College of Physicians and Surgeons of Nova Scotia. She is a former President of the Canadian Association of Emergency Physicians. She is also a former Program Director for the Certification in the College of Family Physicians Emergency Medicine (CCFP-EM) program at Dalhousie University. She has a special interest in evaluation and remediation as well as quality initiatives.

More Physician Extender Programs

~ A Message from the College of Physicians and Surgeons of NS

We value the contribution of physician extenders to the issues of access to care. It’s hard to overstate the impact of physician extender programs. In many instances, the presence of associate physicians or physician assistants enabled departments to remain open.

Physician extender programs are accredited by the College, with established duties, structures of oversight, and scopes of practice. This process is now fully templated, with a minimum of administrative burden.

At the onset of the pandemic, there were 13 physician extender programs in NS, all within the central zone, all housed within academic departments. At the close of 2023, the number of programs has expanded to 29, with new programs located around the province and not always connected to an academic department. These programs employ 63 physician extenders.

There is an exciting, new pilot project for associate physicians working as hospitalists in the northern zone. The project enables successful candidates to progress to licensure as the most responsible physician after two years working as an associate physician. To our knowledge, this is a first of its kind project in Canada, which will also generate a recruiting advantage.

The provincial government amended the regulations to the Medical Act, conferring upon the College of Physicians and Surgeons of Nova Scotia the responsibility and authority to regulate physician assistants within the province, effective April 1, 2024.