NSHA is committed to keeping all physicians up to date with information from the provincial incident management team and all clinical information required to assist in our provincial response.
I want to take an opportunity tonight to thank physicians across the province for their engagement in our webinars, meetings in the zones, and your thoughtful questions and feedback. We are hearing from so many of you, and I am so grateful for the support you are giving the organization in planning and implementing so many changes at an unprecedented pace.
There are challenges ahead. You will need to take time to renew your own energy sources, rest when you can, and manage your own self-care needs. We are working closely with DNS to provide stabilization to those whose work has changed. The medical affairs team is reaching out through the zones for physicians looking for deployment opportunities to our COVID-19 units, secondary assessment centers, support for unaffiliated patients, long term care, and patients who could avoid Emergency departments in the days to come.
We need to support each other and our interprofessional colleagues as we continue to do our part as a system to flatten the curve. The situation, the evidence, and the directives are evolving hourly. Your resilience and commitment is being displayed every single day in all our facilities.
Support, encourage and debrief with each other. Check in with your colleagues to see how they are doing. Ask your physician leader what you can do to help them.
You are an incredible work force of passionate physicians dedicated to the practice of medicine and the people of Nova Scotia. Thank you.
Department of Health and Wellness Requests
The Department of Health and Wellness are raising concerns with the high number of requests from many different departments related to physician and medical staff issues. They will be providing us a templ
ate
to coordinate the multiple requests. Going forward, please send your requests through Grayson Fulmer (
GraysonW.Fulmer@nshealth.ca
) who will ensure the template is updated. This will also ensure that we are supported to coordinate with Doctors Nova Scotia on these issues.
Dal Health Students Step Up for their Future Peers
The ‘Dal Health Students for Healthcare Providers’ group is offering free childcare to health workers between March 23 and April 3, while schools in Nova Scotia are shuttered. Workers interested in enlisting the aid of volunteer students can do so by emailing
DalStudentsforHCPs@gmail.com
or filling out
this online Google doc.
Update from Doctors Nova Scotia
Virtual care announcement
Doctors Nova Scotia has reached agreement with the Department of Health and Wellness (DHW) on new virtual care fees, available to all specialties, which may be used during the pandemic. This announcement is a good first step, ensuring that Nova Scotians get the care they need during this time. People still need help managing their health whether they get sick with COVID-19 or not.
Any visit that would normally be billed as a face-to-face visit may be billed using this code. Any visit that requires a change in how the patient manages their condition, etc. qualifies.
Doctors Nova Scotia will continue to work with the DHW to refine and improve virtual care supports in Nova Scotia. We also hope to have information for you regarding potential virtual care technology solutions very soon.
Read the MSI Bulletin for full details
Repatriating retired physicians
Doctors who have retired in the past three years may be eligible to return to practise. If retired members wish to return to practise, all organizations will work with them to make the process as smooth and easy as possible.
- Doctors Nova Scotia will not require retired physicians to become full members. Their membership category will remain the same.
- The Department of Health and Wellness will pay retired physicians’ Canadian Medical Protective Association (CMPA) dues.
- The College of Physicians and Surgeons of Nova Scotia will not charge fees for licensing.
The College can quickly provide licensure. The
r
estricted licence – restricted to pandemic response as directed by the NSHA/IWK –
has the following criteria:
- Physicians must have practised in the last three years
- The end date for these licences will be June 30, 2020, to be re-visited as required
- No fee will be charged for this licensure
- Physicians must obtain CMPA coverage
For physicians that do not currently qualify: note the above info and be aware that your name will remain on a list as the needs and requirements may change over time as the College stays in close contact with Nova Scotia Health Authority (NSHA) and the IWK. If physicians have questions about this restricted licence, please contact the College at:
registration@cpsns.ns.ca
.
Infection Prevention and Control
Infection prevention and control (IPAC) has provided updated details about aerosol generating medical procedures (AGMPs), specifically with regard to persons under investigation (PUI) for, or with, laboratory confirmed COVID-19.
Click here
for further information.
In addition to
English
, self-screening signage in both
French
and simplified
Chinese
are now accessible on the NSHA coronavirus intranet page.
Many of the questions we’ve been fielding from physicians across the province are related to Infection Prevention and Control. A series of new Infection Prevention and Control resources were added to the physician site today, and can be found
here
Visitor Restrictions
Nova Scotia Health Authority is extending visitor restrictions at all facilities to limit the spread of respiratory illness, including COVID-19. No visitors are permitted in any of NSHA’s hospitals.
There are compassionate and supportive care exceptions in consultation with the care team, they are as follows:
- patients at end-of-life;
- a designated person per patient is permitted in labour and delivery rooms;
- parent/guardian with pediatric patients;
- substitute decision makers as required for plan of care.
In these circumstances, the visitor/ support person will be named and limited to one person. Multiple people waiting in hallways, family rooms or waiting rooms is not acceptable given requirements to social distance. In the case of pediatric patients, an exception may be considered for two parents in consultation with care team.
Guide for Leaving Phone Messages for Clients/Patients
It is important that staff refer to the
guide
to Leaving Phone Messages or Voicemails for Clients/Patients for COVID-19 communication with patients and clients. It includes a reminder about Personal Health Information (PHI), what to say when leaving a message or voicemail, and steps to take in case of a breach.
CMPA Resources for Physicians
Visit the
CMPA COVID-19 HUB
: Updated regularly with FAQs, articles, and additional resources
Learner Placement Cancellations
As of 5PM March 18th, all learner placements at IWK and NSHA are immediately postponed until further notice, inclusive of programming at the Registered Nurses Professional Development Centre (RNPDC), and the QEII Simulation Program (except specific to COVID-19). Only specific licenced health care providers (e.g. medical residents, nurse practitioners) who are also on clinical placements will remain in service.
This directive also includes Dalhousie University clinical clerkship for medical students.
Practice Ready Assessment Program
The Nova Scotia Practice Ready Assessment Program (NSPRAP) has made the difficult decision to postpone the clinical field assessments until the fall of 2020. This decision was made based on the risks and uncertainties involved with carrying out an impartial assessment in a clinical setting that will be strained by the COVID-19 pandemic. The NSPRAP team believes it cannot ensure the health and safety of the candidates and the assessors in these circumstances. We are aware of the impact this will have on the clinical sites and communities. As such, NSHA supports this decision and will circle back in the upcoming months to ensure that we re-identify the opportunities in your community.
Business Continuity Management – COVID Inpatient
- a provincial variance from continuing care to allow for placements from NSHA facilities.
- requesting DHW communicate with LTC facilities and reinforce that:
- ALL residents of Long Term Care Facilities should have assessment of goals of care and current care directives clearly flagged in their record. No Long Term Care residents should be transferred to acute care hospitals if their goals of care do not include interventions that require hospitalization.
- Long Term Care Facilities should identify areas of the facility to which patients with suspected/confirmed COVID patients can be cohorted.
Fit Testing for Physicians
Only physicians who are providing aerosol generating procedures (positive pressure ventilation (BiPAP and CPAP), endotracheal intubation, airway suction, high frequency oscillatory ventilation, tracheostomy, chest physiotherapy, nebulizer treatment, sputum induction, and bronchoscopy) should be participating in fit testing at this time. Staff members are working to reach all physicians in each zone to determine their fit testing status.
For information about fit testing in your area, contact your zone Occupational Health and Safety Lead:
*new* Upcoming Fit Testing Clinics for Physicians in the Western Zone
Fit testing takes approximately 15 minutes.
You must be clean shaven or you will not be fit tested.
Thursday 19 March: VRH Admin Meeting Room, 0800-1200 (longer if demand exists)
Friday 20 March: SSRH Conference Room 1078, 0800
–
1200 (longer if demand exists)
Enhanced Access in UpToDate for Physicians
New open access articles have been added to UpToDate for anyone seeking the latest evidence-based updates.
Additional Related Topics from UpToDate
Health Care Facility Construction and Renovation Pause
All construction and renovation activity that is currently ongoing inside NSHA Health Care facilities should be paused at this time. This includes projects that are under Transportation and Infrastructure as well as NSHA direction.
Facilities Management and Support will continue to support essential projects and maintenance of all facilities and equipment as required.
This recommendation is not made lightly but informed by the directions and information shared by the Public Health and Government directives in Canada and Nova Scotia. The wellbeing and safety of patients, families, staff and workers on our sites is foremost as we make this recommendation.
Nova Scotia Government Update
As of today, Nova Scotia has three confirmed cases and nine presumptive cases of COVID-19.
Five new cases were identified Tuesday, March 17. Four of the cases are travel-related and one is connected to an earlier case. The 12 individuals affected range in age from early 30's to mid-70's. They are all in self-isolation and recovering at home.
Public health has been in contact with these individuals and working to identify others who may have come in close contact with them. Those individuals are also being directed to self-isolate at home, away from the public, for 14 days. They are located across the province. Northern Nova Scotia is the only region without a positive case of COVID-19 at this time.
The province is testing daily, working with our partners at the National Microbiology Laboratory in Winnipeg. To date, Nova Scotia has 1,141 negative test results, nine presumptive positive cases and three confirmed cases.
If you have been in close contact with someone who has travelled and are experiencing fever (above 38 C) and/or new cough you should complete the online questionnaire before calling 811. The online questionnaire can be found at:
https://811.novascotia.ca/
Further Measures Announced Today
Effective immediately:
-- doctors and pharmacists have new options for virtual care, using telephone and secure videoconferencing
-- pharmacists can renew prescriptions for most medications and government will cover the assessment fee
-- employers cannot require a doctor's note if an employee must be off work
-- College of Physicians and Surgeons waiving the fee for retired doctors to renew their licences so they can come back to work
-- retired and other nurses are being brought into the system to assist with 811 staffing
-- all service providers funded through the Department of Community Services' Disability Support Program - including social enterprises, day programs, and supported employment programs for adults with diverse abilities will close to participants and the public
Effective midnight Thursday, March 19, personal service and fitness establishments such as hair salons, barber shops, spas, nail salons, body art establishments and gyms must shut down.
Incident Management Team: Clinical Services Advisory Representation
