Each year on Sept. 17, World Patient Safety Day provides an important opportunity to raise awareness, share knowledge, and highlight initiatives that protect the health and well-being of patients around the globe. This year, the theme “Safe care for every newborn and every child” emphasizes the vital role of safety in ensuring healthy beginnings and brighter futures.
Patient safety is not just a priority; it is also the collective responsibility of our healthcare teams. For newborns and children, safe care means more than clinical excellence; it means creating an environment in which families feel supported, risks are minimized, and every child has the opportunity to grow and thrive.
Nova Scotia Health is deeply committed to advancing patient safety for parents, infants and children. From strengthening care practices to building awareness among teams, our initiatives reflect the belief that safe care is the foundation of healthy communities.
Today, we are highlighting three initiatives that support children at different stages of development: during pregnancy and in utero, in the time surrounding birth, and later in childhood and adolescence. These include initiatives such as improving responsiveness to postpartum hemorrhage, enhancing safety in neonatal and pediatric care, and expanding access to gender-affirming.
Improving Safety for Birthing Person and Children in Eastern Zone
An important initiative at Cape Breton Regional Hospital and Saint Martha’s Regional Hospital is strengthening how staff respond to postpartum hemorrhage (PPH).
PPH affects about 10 per cent of deliveries and is one of the leading causes of maternal death. To tackle this serious issue, the team partnered with the moreOB program, a performance improvement program that fosters a culture of patient safety in obstetrical units. The program helped identify gaps in care and align practices with the Society of Obstetricians and Gynaecologists of Canada guidelines.
“Physicians and nurses complete an online education module and then take part in a collaborative workshop,” said Charlene Candelora, clinical nurse leader of Family and Newborn Services at CBRH. “We focus on best practices in risk assessment, role clarity, staging, quantitative blood loss, and medication management.”
This work is already creating change. Staff feel more confident using consistent tools and training, patients benefit from clear communication and proactive care, and teams are building stronger collaboration by identifying effective practices together. The result is safer outcomes for patients through earlier recognition and treatment of PPH, and a more supportive medical experience for patients giving birth and their newborn overall.
Kelley Lundrigan is the manager of Women & Children’s Health at CBRH. She’s impressed by how well teams are working together on this initiative. “I’m really proud of how our teams are collaborating between hospitals. This work is all about collaboration between staff and strong teamwork,” she said.
Candelora agreed, adding that leadership encouragement is essential. “We wouldn’t have been able to spread this enthusiasm without leadership support,” she explained. “When frontline staff feel encouraged, that energy ripples outward to others and sparks new ideas for improvement. It allows the core team to step up as leaders in their own right, and that has been key to how this initiative has rolled out.”
This initiative is helping create safer care for people giving birth, newborns, and children in Eastern Zone.
Public Health Early Years Supports Growing Families
Public Health Early Years is a provincial program that supports families across Nova Scotia, with services delivered locally in each zone. In Central Zone, the program provides care and helps connect families with services during pregnancy and in the early stages of childhood.
“Early Years is an important part of the support system for families during a time when there’s a lot of change and new challenges. This connection is especially helpful for those who are navigating first-time pregnancy and parenthood,” said Katherine Malec, manager of Early Years in Central Zone.
Traditionally, families have been connected through hospital-based screening, where Public Health nurses (PHNs) meet them soon after birth and provide referrals to the right supports. But research shows that connecting with families earlier – in the prenatal period – leads to better outcomes. To make this shift possible, a standardized provincial referral form has been introduced. This creates a consistent process across the province and helps establish clear prenatal referral pathways between primary care providers and partners and Public Health Early Years. With earlier referrals, PHNs can provide health education and connect families to supports and services before birth, improving outcomes for both parent and baby. The goal is to ensure clients receive the right care, at the right time from the right providers or services.
PHNs are at the heart of this work. They meet one-on-one with families to learn which Early Years services best suit their needs and continue to provide support during pregnancy and after the baby is born.
PHNs guide and support families on a wide range of issues, including infant feeding, sleep, mental health, growth and development, immunizations, nutrition, parent–child relationships, and social supports. They also work closely with allied health professionals and community organizations to make sure families have access to the best information and services available. This collaborative approach helps families feel supported and confident as they navigate pregnancy, birth, and early childhood.
Sometimes, PHNs are the first to recognize when urgent medical care is needed. “In that moment, the nurse might realize a baby is in distress and needs to be seen right away,” said Tina Swinamer, manager of Early Years in Central Zone. “That could mean emergency, a primary care provider, or 811 for triage.” Other times, PHN’s can support families in identifying supports in their communities, family resource centres, food programs, education programs. They can also support families in navigating the health system and when to seek medical care.
Knowledge-sharing among PHNs is another cornerstone of the program. “We have working groups within our Public Health nurse network,” said Malec. “One is focused on supporting newcomer families and has developed and translated resources and materials to help both families and staff. We also use discussion and information sharing to strengthen our support of each other and the clients.”
All Nova Scotia residents who are pregnant or have young children can access support from Public Health. Families can contact Public Health directly or be referred to Early Years by a healthcare provider or community organization, such as a Family Resource Centre. Accessing services is encouraged as early as possible in pregnancy. While a referral to Public Health Early Years in pregnancy is ideal, a referral can be made at any time until the child is 5-years-old. Families can expect to hear back within a few days.
By combining clinical expertise, standardized referral processes, community connections, and shared learning, Public Health Early Years is helping families thrive – starting even before a baby is born.
Expanding Access to Gender-Affirming Care in Nova Scotia
Nova Scotia Health is advancing gender-affirming care through new dedicated clinics and ongoing capacity-building initiatives. Two gender affirming care clinics have already been established: one in Kentville in February 2024 and another in Bridgewater in March 2025, with plans for more across the province.
These clinics provide evidence-based care for trans and gender-diverse youth seeking affirming hormone therapy and puberty blockers, along with wraparound supports to ensure a safe and supportive care environment. Services follow the World Professional Association for Transgender Health standards of care, the most current international guidelines. According to the Canadian Paediatric Society, gender-affirming care — healthcare that supports a person’s gender identity — is the standard of care for trans and gender-diverse youth.
This work is further strengthened by the Child & Adolescent Capacity Building Project, also known as the Clinical Care Pathways initiative. “The project has been ongoing for several years and was recently evaluated,” said Kady Myers, Mental Health and Addiction Services senior analyst supporting child and youth. “Its goals are to ensure clinicians have access to the most up to date, evidence-based information, to provide consistent high-quality care across the province, and to allow flexibility so services are personalized and culturally relevant.” Each pathway is developed with input from experts, regularly reviewed, and adapted to meet emerging needs.
Another important advancement is the adoption of the CAPA framework (Choice and Partnership Approach) for child and adolescent mental health and addictions care. CAPA emphasizes collaboration, shared decision-making, and active participation from young people and their families. It improves both access to and quality of care and is supported by an advanced practice lead role, which provides clinicians with training and ongoing guidance.
These efforts are expanding access, improving quality, and ensuring gender-affirming and mental health care for children and youth across Nova Scotia.
Thank you to all staff, physicians, partners, and volunteers who support patient safety in our facilities and communities each and every day.
Photo of the team behind gender-affirming care clinics.
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