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Single-Entry Model for Surgical Referrals

As part of Nova Scotia Health's Surgical Access and Quality Improvement Strategy, planning is underway for a single entry model  (SEM) for managing and coordinating surgical consult referrals in Nova Scotia.  It will be supported by an eReferral tool (Ocean) and central intake office and allow for referrals to both Nova Scotia Health and IWK Health surgeons.

This initiative is also among the priorities and commitments in government's Action for Health Strategic Plan and will support efforts to improve access to surgical care, reduce wait times and improve the overall experiences of our patients. 

The new model is scheduled to launch on March 31, 2023.

The Ocean tool supporting surgical eReferrals, will also be used to support the new Diagnostic-Imaging eRequisition Model launching later this year. This means that providers set up to use Ocean will be able to use the tool for both surgical and diagnostic imaging referrals.

View our Frequently Asked Questions.

Join us March 27 for a Webinar on our new model hosted by Doctors Nova Scotia.

 

Expected Benefits

 
For Patients
  • Improved communication about consult status / what to expect
  • Continued choice / more informed choice (wait times, etc.)
  • More equitable access to services 
  • Help reduce waits for consults
  • Timely triage to prioritize care

For Providers
  • Consistent and complete referrals
  • Less administrative burden for primary care providers
  • Comprehensive / up-to-date surgeon registry
  • Continued choice by referrer
  • Less administrative burden for surgeons and specialists with appropriate referral information
  • Helps surgeons build practices, supporting recruitment / retention

System Benefits
  • Access to consult queue data to better plan and allocate resources
  • More consistency and coordination
  • Opportunities to better distribute demand across system

 

What is Planned?

The single-entry model proposed for Nova Scotia includes the following components:

  • Central intake – a single point-of-entry through which referrals are received and service provision is arranged
  • Centralized consult wait list
  • An electronic referral tool / application to support  timely,  complete, decision-ready referral

 

What happens now? 

In traditional “multiple queue, multiple server” models (i.e. for most scheduled elective services), individual primary care providers refer to individual specialist physicians, through a referral letter. Each specialist manages their own waiting lists and patient appointments. When a new patient is referred and all appointment slots are occupied, the patient must wait. Given that the management of waiting lists in this model is dependent on individual specialists, there can be substantial variation in the scheduling process and surgeon capacity. Differences in practice within and across jurisdictions can also add to this variability, ultimately affecting wait times and patients experiences and outcomes.

 

Provider engagement

We recognize you may have questions or feedback regarding what this could mean for your practice and patients. We are committed to working with referring providers, surgeons, patient representatives and others to explore options, answer your questions and find the approaches that will work best for our patients and health care teams.

How can you get involved and stay informed?
  • ***ONBOARD to the Ocean eReferral Tool now*** 
  • Provider surveys:  Surveys were open to surgeons and referring providers in the summer of 2022. These were aimed at helping us understand how referrals are now submitted / managed and to seek provider perspectives related to this initiative. You can view a high level summary of results here. The compiled responses were shared with the project steering committee and working groups to support planning.
  • Participate in planning:  Representation from referring providers and surgeons has been routinely sought on our planning teams and to support the clinical review and development of implementation plans, forms, processes, training resources and more. Through our survey in the Summer of 2022, nearly 60 providers expressed their interest in supporting this work. 
  • Learn more or offer feedback: 
    • Check back on this page for ongoing updates
    • SIGN-UP to receive Single-Entry Surgical Referral Project Updates
    • Visit our Nova Scotia Referral Resource Hub - www.referralsNS.ca
    • SUBSCRIBE to Perioperative Network Highlights for regular updates on the Surgical Access and Quality Improvement Strategy, Single Entry Access Model and other Perioperative Services initiatives and topics
    • Share your questions / suggestions with zone leaders (i.e. Chiefs/Heads of Surgery or Family Practice, site leads or others).
    • Message our Perioperative Services Network  - Perioperative.Services@nshealth.ca

 

Topic Menu

  • Overview

Helpful Links

Webinar with Doctors Nova Scotia - Oct. 6/22
View Project Updates
Frequently Asked Questions - Updated March 9/23
CMAJ August 2022 - Revisiting the concept of urgency in surgical prioritization…
SUBSCRIBE to Perioperative Network Highlights
Single-entry Referral Comes to Nova Scotia - Doctors Nova Scotia Magazine Feb 2…

Related Documents

Documents:
High Level Survey Results - Single-Entry Intake Model Survey (Summer 2022) FAQs - Single-Entry - 03.09.23.pdf

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