To: Family physicians and nurse practitioners

04-07-2020

In order to safely support you and your patients, work is moving forward to expand the scope of the Primary Assessment Centres and to provide PPE for family physicians in the community.

Expansion of Primary Assessment Centres for all Respiratory Illnesses

As the symptoms of COVD-19 are difficult to distinguish from other respiratory illnesses on clinical grounds alone, it is prudent to evolve our approach by “cohorting” all patients with acute respiratory infections. Starting now, please refer all patients with COVID conditions and ILI symptoms to the nearest primary assessment centre. This will enable NSHA to supply the appropriate PPE for those who are providing care at these locations.

Existing primary assessment centre locations are being expanded and a few more are being established to manage anticipated increases in patient volumes in the weeks ahead. The centres will both assess and provide treatment for patients. We will be reaching out to primary care providers to support this expanded scope, and you can self-identify your interest in working in a centre near you using this link.

The Nova Scotia government has communicated that travel has been removed as a criterion for COVID-19 screening. The 811 online self-screening tool has been updated to the following criteria: fever of 38 degrees or a new or worsening cough. Our screening guide for family practice has already been updated to reflect this change.

PPE Update for Family Practice

Earlier today you would have received an email from NSHA CEO, Dr. Brendan Carr, about PPE, and the decision to supply all health care providers with a mask for all patient encounters.

For community-based providers in family practice, two masks per family physician / nurse practitioner per week will be supplied by NSHA from a centralized location in your area. More information about the distribution process will be shared shortly as details are finalized over the coming days.

Based on this, we are expecting that you limit in-person appointments to one day per week in your practice. You will have one mask to wear for that day and a second as a backup. In order to support physical distancing, coordinate with your colleagues in your clinic to provide in-person care on different days, and this also provides access for patients over several days per week.

As an alternative, family doctors in each community (or neighbouring communities) may want to consider working together to identify one (or more) practice location(s) where all in-person non-respiratory illness care can be provided, where a select group of primary care providers offer appointments for all patients from that community or providers take turns at the location to see their own patients and/or patients from their group practice. For communities interested in this approach, please contact your family physician network lead who can help to coordinate this.

Wearing the same mask throughout the day during in-person office appointments will help to protect your patients, and referring all patients with respiratory symptoms to your local primary assessment centre will limit exposure to the virus for yourself, your staff, and your other patients.

NSHA has enough PPE to meet the current need in the short term; the organization continues to source and distribute additional PPE using a streamlined approach. It is important that we responsibly manage our PPE; by referring patients with symptoms of respiratory illness to primary assessment centres, and limiting in-person non-respiratory appointments to only those deemed necessary, will enable us to supply the appropriate PPE for those who are providing care.