ANNUAL CHECKUP
Provincial health agency making progress
Scott Livingstone’s job seems impossible, but that hasn’t stopped him from doing it.
The Saskatchewan Health Authority’s first CEO oversees the ongoing amalgamation of the province’s 12 health regions into one giant authority. The goal is to scale the best of each health region and make it provincewide practice — all without disrupting existing care.
“You’re flying this jumbo jet and you’re building it at the same time,” Livingstone said. “Regardless of what changes have gone on in the last two years, we still have to take care of patients every single day.”
It was a big year for health care. Saskatchewan opened its first children’s hospital with its fair share of headaches. In Regina, the Opposition NDP put health care in their crosshairs. Near the end of the year, a provincial auditor’s report concluded the SHA had to do better to prevent suicides in the province’s northwest, which had more than double the country’s average suicide rate in 2018.
In the background to all of that is the megaproject that is amalgamation. The SHA inherited 14,000 policies — 10,000 of them clinical and 4,000 administrative. The 53 policies that will reach the board next year would eliminate as many as 1,800 of those.
Livingstone acknowledges he didn’t expect the level of difference between various parts of the province — in everyday practice and culture.
“It surprised me, the amount of variation we saw as we start picking up those proverbial rocks and see what crawls out,” he said. “That type of (operational) variation, which is unintended, puts people at risk. Because as a single organization, you want consistency on patient flow, how we communicate with patients and how we deal with patients so their experience is consistent.”
Despite this, Livingstone said the new structure was yielding results from Day 1.
He pointed to the authority’s response to the Humboldt Broncos crash, which happened just four months into its creation, as an example of how having a single entity helps coordinate the province’s resources.
“To be able to have that provincial lens and to prioritize resources where we need them is a huge advantage,” he said. “We’re much more nimble than we were as 12 different organizations when it comes to responding to these kinds of things.”
The health authority scored 94.5 per cent overall on its most recent federal accreditation, and 100 per cent in areas like standards of governance, which Livingstone said is “almost unheard of ” for an organization so young.
The year’s biggest highlight was the opening of the Jim Pattison Children’s Hospital, a project 12 years in the making.
“We know in pediatrics we’re never going to be able to do everything for everyone, but this is a huge step forward,” Livingstone said. “To be able to have that facility and expertise associated with that facility provincewide is pretty exciting.”
Not all the year’s headlines were so positive. The NDP regularly circulated reports of understaffing or infrastructure problems at SHA facilities, often laying the blame on the government — and upping pressure on the SHA.
Livingstone’s response to reports of ER wait times has been to own the problems.
“It’s all factual. We’re not getting these red herrings thrown at us and chasing our tail,” he said. “The workaround system flow and managing capacity issues is work every health care association in North America is grappling with.”
Livingstone said the ER has become the de facto destination for sick people — especially the 23 per cent of people in Saskatchewan who live with a chronic disease. Those acute care beds are the “single most expensive part” of the health care system, ramping up costs and wait times, he said.
Ideally, the solution would be to prevent people from ever needing to go the ER — but that’s not something the authority can do alone.
“The health system has a very, very small impact on the overall health of the population,” Livingstone said. “We have one of the most unhealthy populations in the country. Those outcomes have taken us decades to generate. This is not something that happened in the past five years.”
He hopes documents like the province’s 10-year Mental Health and Addictions Action Plan will mean broader approaches to complete care. But he’s not optimistic that’s happening.
“I think government has tried to address this for years and years and years, and I’m not sure what successes there are,” he said.
Livingstone likes to joke that the most common question he’s asked by reporters is, “How’s it going?” — seemingly in reference to everything.
“Now, when I get asked that question, I can say, ‘We’re doing OK,’” Livingstone said. “We’re seeing significant progress across every area we’re working on. We’re not sitting stagnant.”