Sackville’s ER has been operating outside of its purpose-built space for five months now, ever since a flood caused by a water main break put the unit out of commission in September 2022. But that will end next week, when staff and equipment will be able to move back into a repaired and renovated ER.

Horizon did the $400,000 renovation with their in-house facilities team, and while there is no new equipment acquired as part of the project, the space has been modernised with new floors and furniture. Nurse manager Brittany Nicholson took local officials on a tour of the renovated space on Thursday, as part of a celebratory event hosted by Horizon. Nicholson says the reno has brightened up the space, and brings it in line with the design of Horizon’s regional centres.

“It definitely makes it a little bit better,” says Nicholson. “It’s a little bit easier space to work out of.”

Horizon CEO Margaret Melanson told the gathering that the project hit on all four of the health network’s critical priorities: improved access to health care, community engagement and patient experience, patient flow, and recruitment and retention of staff.

“The investment of $400,000 will give staff a fresh and modern work environment,” said Melanson, “and it will certainly improve patient experience as well. Modern work environments are also a selling point when it comes to recruitment and retention of our staff and physicians. This along with our work with the Rural [Health] Action Group will help us recruit more health professionals to this vibrant rural community here in Sackville.”

Melanson acknowledged that the hours of the ER would still not be returning to their previous 24/7 standard, though she said the renovation shows Horizon’s commitment to the hospital and the Sackville community. There have been recent successes in hiring nursing staff and a concerted effort from Horizon and local volunteers, but there is still a shortage of doctors, with at least five more doctors needed before the ER could return to 24/7 service.

“I can tell you that we are continuing our recruitment work to find those who are the right fit for this hospital,” said Melanson. “And it’s our commitment to reopen on a 24/7 basis as soon as we are able to do so.”

Melanson said “stability of staff” is key to the expansion of service hours. “We certainly don’t want to be extending hours and then have to reduce again,” said the Horizon CEO.

The current service hours for the Sackville ER mean it’s open eight hours per day, even less than was proposed by a former Horizon management team in February 2020, a proposal which sparked protests in Sackville and other rural hospital communities.

Moncton-Sackville ER collaboration?

Melanson named a few strategies being considered to fill the required medical staff positions in the ER. One is the possibility of allowing Moncton ER doctors to pick up shifts in Sackville, something which currently happens between Sussex and Saint John hospitals. Another is “expanding the skill mix” by allowing physician assistants and nurse practitioners to take on a role in the ER. Melanson offered no timeline of when those policy decisions might get made.

Last year, Sackville doctors collectively decided to end a practice that required the area’s family doctors to also work shifts in the ER. That policy change immediately led to the loss of a number of ER doctors. While it’s expected the policy will make it easier to recruit family physicians who want to focus on community care, Melanson noted that ER doctors might not be easy to recruit to work exclusively in a small town hospital.

”A physician trained in emergency medicine would want probably to be associated with a larger centre in addition to a smaller site such as this,” said Melanson.

Health care vision up for discussion between RHAG and Horizon

Former Sackville mayor John Higham was part of the announcement on Thursday, in his role as co-chair of the Rural Health Action Group (RHAG). In December, the group submitted a vision for health care in the region to Horizon, though the document has not been released publicly. In his remarks on Thursday, Higham referenced that future focus.

“Let’s celebrate today,” he said, “and tomorrow, we hope that we can enter a new collaboration with even higher aspirations for the health system in this area. That’s what we’d like to see next.”

CHMA has requested a copy of the vision document being considered by Horizon, but both the RHAG and Horizon communications staff have declined to share the document publicly. Higham said via email that some RHAG members had met recently with Horizon to discuss the vision, and RHAG leadership would be briefing the wider RHAG membership, as well as the area municipalities.

Future of health care governance, and a role for community?

Health minister Bruce Fitch was also at Thursday’s announcement in Sackville, and harkened back to his days as a Mount Allison student. Fitch became Minister of Health last summer at the same time that Premier Blaine Higgs scrapped the partially-elected health boards that previously governed Horizon and Vitalité Health Networks, and fired then-Horizon CEO, John Dornan.

CHMA asked Fitch what kind of role community members would play in future health care governance in the province, and the minister said a new governance model would be in place by the end of the year. Fitch said governance is “something that we continue to discuss,” but shared no details of what alternatives were under consideration.

“Part of that, again, would be looking at where does the community play [its role]? What’s the role of the board, and what would that look like? And how does the government work with the CEOs and their teams? So there’s a lot of work being done,” said Fitch. “And we’ll roll that out in the future.”

It’s a celebration, but…

Memramcook-Tantramar MLA Megan Mitton was in the crowd on Thursday and said she felt it was important to celebrate the ER renewal, but, “I look forward to a bigger celebration when it’s open 24/7.”

“We can’t lose sight of where we ultimately want to go,” said Mitton, “which is 24/7 ER services in our community,” as well as “more access to primary care.”

Both Tantramar’s mayor and deputy mayor were also on hand. Mayor Andrew Black said he was celebrating, and was confident that all present were on the same page as far as future ER services are concerned.

“I think the message is pretty clear that there’s still work that needs to get done,” said Black. “It is a celebration. I mean, we do have the emergency department back up and running [in its dedicated space]. But next steps need to be taken, and we’ll continue to work on that.”

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