Assignment 3
Introduction
Thirteen weeks ago, I started the journey towards a Master of Health Studies. I was not quite sure what to expect, not creating an E Portfolio. The development of the E Portfolio felt like a daunting task. Once developed it was surprisingly easy to maintain. At the start of the course I did a social media audit and was surprised to discover I was attached to several platforms even though I do not actively participate on them. My main purpose was to monitor what my children were posting. It got me thinking about my social media presence in regard to being aware that anyone can view what I put out in the digital world and that it is there to stay. Before I was more concerned of my children’s actions.
Professionalism
My licensing body is the College of Registered Nurses of Nova Scotia (CRNNS) through which there is a set of standards and code of ethics that I am required to adhere to. There is also a set of policy and procedures that I am required to follow to remain employed as a RN at the Nova Scotia Health Authority. I am bound to work within my scope of practice. The college provides a variety of services to the nursing profession for example they will clarify practice issues and provide needed resources. We are also represented by a nursing union to address issues that may arise with our employer.
Health Systems in Canada
Throughout this course I have learned more regarding the role Nova Scotia plays on the health of Canadian citizens. Nova Scotia is making strides in this, especially when it comes to access to services. The province is moving towards a Collaborative Interdisciplinary approach to health care. The collaborative approach may look different in each community. It may be made up of physicians, nurses (family practice or nurse practitioners), paramedics midwives and mental health workers. https://novascotia.ca/dhw/primaryhealthcare/CEC.asp
Any combination of these health care workers can be found as a team in any number of the eight Collaborative Emergency Centres(CEC) around the province. This model was developed due to the emergency rooms in rural communities not being adequately staffed with emergency physicians with the first CEC opening its doors in 2011. The province plans on opening another six CEC’s. https://www.cbc.ca/news/canada/nova-scotia/collaborative-emergency-centres-get-passing-grade-1.2867036.
With the significant health challenges Nova Scotia is facing the province is moving towards a population health approach since the traditional approaches have not been successful. This type of approach consists of citizens from a variety of backgrounds that will identify and build upon ideas that will make and keep their communities healthy. Lessons learned from this type of approach is that having different views on a problem can help find the appropriate solution. People need to work together. Effective partnerships need to have adequate time to collaborate. It is important to include the policy and decision makers. Expertise of community members is crucial. Finally, evaluation needs to take place to ensure the correct strategies are put in place to have the most positive influence on the determinants of health for the community. (Healthy People, Healthy Communities: Using the Population Health Approach in Nova Scotia).
Determinants of Health
Health providers have long recognized that social factors greatly influence the health of their patients. Across societies, socially disadvantaged populations are at a much higher risk of having poor health. Social Determinants of Health is becoming more of a priority as our societies are becoming more unequal in relation to wealth, income and job security. This in turn appears to be related to the growth in health inequalities. (Pinto,A.D., Bloch,G., Can Fam Physician, 2017 Nov; 63(11)).
Social Quality Theory Framework and Chronic Disease in Nova Scotia
In the process of learning about my home province I selected the Social Quality Theory Framework to relate an individual’s physical fitness to the environment they live in. Social Quality suggests that neighbourhoods’ matter for health because they provide the local social conditions that enable people to see themselves as social beings and experience well-being. (Holman et al., 2018).
Whereas the Social Determinants of Health framework concentrates on risk factors for health, social quality is concerned with risk factors for social participation and realisation, which in turn are assumed to influence health and well-being (Holman et al., 2018).
Four factors govern the extent and quality of social participation:
· Socio-economic Security
· Social Cohesion
· Social Inclusion
· Social Empowerment
Income inequality wears down social cohesion as well as lessons socioeconomic security, disconnects relations/institutions and interferes to the degree that institutions/relations empower people (Holman et al., 2018). Not only does Social Quality Theory relate to physical fitness participation but it can also be used in relation to chronic disease in Nova Scotia. Low income groups have higher rates of smoking, obesity, physical inactivity and cardiovascular risk. The Nova Scotia Chronic Disease Prevention Strategy also recognizes the importance of mental health as a key determinant of chronic illness and a central feature of well-being. Studies have shown that in addition to depression and stress, certain emotional states and personality types are risk factors for hypertension, heart disease and other chronic illnesses (Major Health Issues in Nova Scotia, 2009). Nova Scotia Health goals are similar to the Social Quality Theory Framework.
Vulnerable Populations
Progressing through this course I went from a general focus to health-related issues in our country to issues closer to home. The homeless population in Halifax was the vulnerable population I chose to focus on. Looking back on the units, all the issues discussed are intermingled. These people do suffer from chronic disease, do not have easy access to healthcare and do not live in healthy neighbourhoods that have access to physical activities. This is a widespread problem and governments on all levels need to address it. At the municipality level there is the Mobile Outreach Street Health plays a large part in assisting the homeless in accessing health care services. It is a collaborative primary health team that consists of full-time nurses, part-time occupational therapists and support from physicians. The team meet people at locations where the homeless person feels safe. They take primary care to them and the team builds trusting relationships with this population it improves health outcomes. The team provides these services at a variety of shelters and organizations or on the streets throughout the Halifax Regional Municipality (Mobile Outreach Street Health). In 2007 the Nova Scotia provincial government passed the Poverty Reduction Working Group Act. An appointed group is given the responsibility of making recommendations for a poverty reduction strategy. Included in this group is someone representing Aboriginal interests. Not all provinces require representation of Aboriginals, but it is encouraging that Nova Scotia does as they are too a vulnerable population.
In 2009 the Preventing Poverty, Promoting Prosperity Strategy was introduced with provincial and federal investments. Its goal is to break the cycle of poverty by creating opportunities for people to participate in what the province has to offer and enjoy a better quality of living. The four main goals are: enable and reward work, improve supports for those in need, focus on children and finally collaborate and coordinate (Nova Scotia Poverty Progress Profile).
Future Trends in Orthopedic Care in Nova Scotia
This was interesting research. I am proud to see a couple of local surgeons developing an app and using 3D technology to provide better quality care to Nova Scotians. Dr. Hurley, an orthopedic surgeon at Dartmouth General Hospital is the CEO of the company Conceptualiz Inc. It is an in-house medical 3 D printing company. This company provides user- friendly, time-efficient and cost-effective solutions by producing patient specific surgical planning models (http.//www.conceptualiz.com/index.html).
Dr. Dunbar, an orthopedic surgeon in Halifax has developed a mobile app with the help of specialists, nurses, allied health care workers and hospital management. This technology was developed to decrease the number of patients having to travel a long distance for an in-person visit. The Gait Monitoring System (GMS) is designed to allow patient evaluation without travel or wait time. This app would be used for post surgical follow-up and for people that do not require surgery this app will provide a quick answer and will be able to explore other options with their family physician sooner. Dr. Dunbar envisions that patients will remain in their home and through this app have doctors and physiotherapists evaluate them. Dr. Dunbar’s team has received a 2.5-million-dollar grant from the Atlantic Innovation Fund called Movement at Capital Health (M@CH). This technology will improve access, deliver personalized care and both patients and doctors will see higher satisfaction. By commercializing this app, M@CH plans on putting the revenue’s right back in to the province’s health-care system.(https://www.yourdoctors.ca/doctors/bio/dr-michael-dunbar).
Another program that Nova Scotia is in the process of rolling out is One Patient One Record. Improved technology in Health Care would facilitate proper tests and exams being ordered for clients. For example, physician offices, hospitals and pharmacists all use a computer system but unfortunately neither one communicates with the other. The province is moving toward implementing One Patient One Record (OPOR). This should result in a more timely, safer and efficient delivery of care https://www.yourdoctors.ca/blog/health-care/e-health-what-it-is-and-why-it-matters. This should provide better communication between all health professions involved in a client’s care as well as improve the referral process which will lead to a timely diagnosis and therefore timely treatment, if needed. OPOR will allow the government and the Nova Scotia Health Authority to keep track and monitor the health trends to better serve the people of the province. https://www.yourdoctors.ca/blog/health-care/e-health-what-it-is-and-why-it-matters.
As OPOR is getting ready to be rolled out, there is already an online health record that is already an online health record that is currently being used. This tool is MyHealthNS and is being used by Dr. Gregoire.https://www.yourdoctors.ca/blog/health-care/e-health-what-it-is-and-why-it-matters. It allows patients and physician to share information and communicate online resulting in easier access to their family physician since many people experience a tough time in getting an office appointment.
With these programs being implemented I feel that the province is trying to provide efficient access to health care to its citizens.
Conclusion
This course has made me more aware of the inequities of health care and vulnerable populations. Working in the OR you are consumed by performing surgery but when you encounter someone without friends or family to care for them this causes me to reflect on their life circumstance. I will endeavor to include an assessment of social factors as part of the preoperative assessment to ensure that any person from any walk of life receives quality healthcare. Sometimes it’s as simple as providing a way home.
Resources
Conceptualiz partners with Nova Scotia Health Authority.
Holman, D., Walker, A. Social Quality and Health: Examining Individual and Neighbourhood Contextual Effects Using a Multilevel Modelling Approach. Social Indicators Research.(2018).138(1) p. 245-270.
Kronstein,A., (2017 May 5). The social determinants of health in Nova Scotia. Part1: Poverty makes you sick. Retrieved from https://nsadvocate.org/2017/05/11/the-social-determinants-of-health-in-nova-scotia-part-1-poverty-makes-you-sick/
Major health issues in Nova Scotia: An environmental scan. Prepared for Nova Scotia research foundation. (September 2009). Retrieved from:https://www.nshrf.ca/sites/default/files/environmental_scan_-current_major_health_issues.pdf
Mobile Outreach Street Health. Retrieved from: http://www.cdha.nshealth.ca/primary-health-care/mobile-outreach-street-health-0
Nova scotia chronic disease prevention strategy (October 2003). Retrieved from:https://novascotia.ca/dhw/healthy-communities/documents/Nova-Scotia-Chronic-Disease-Prevention-Strategy.pdf
Nova Scotia Poverty Progress Profile, Canada without poverty, 2015.Retrieved from: https://www.cwp-csp.ca/resources/sites/default/files/resources/ProvincePovertyProfiles-NS.pdf
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