Increasing access to quality health care for people living in rural and remote areas of the province remains a high priority for Newfoundland and Labrador (NL) Health Services, especially when it comes to specialized services like respiratory care.  

Respiratory disease is a major cause of mortality and morbidity, and represents a high rate of chronic disease in our province. Chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) often require timely diagnosis, ongoing monitoring, and education. However, the availability of local resources in small communities and long travel distances to a larger hospital can sometimes impact access and uptake of testing and treatment. Furthermore, it is important that patients have access to the tools to self-manage and take control of their lung disease, yielding a better quality of life. 

In 2024, NL Health Services’ provincial Comprehensive Respiratory Care (CRC) team established a partnership with the health-care team in Labrador to offer virtual services for the first time in Nain. CRC is an innovative, practical strategy to improve and promote lung health through bridging the gap between acute and community care, and improving access to evidenced-based specialized care. The program offers multiple services – all targeted at self-management, comprehensive assessments and education for patients living with chronic lung disease.

Expansion of Services

We are pleased to share that the CRC team has now expanded the partnership and recently offered the first travel clinics in Happy Valley-Goose Bay, Nain and Hopedale.   These clinics will continue in the future based on community needs.

“These clinics provide accessible, community-based services that include diagnostic testing, as well as education and tools to help patients self-manage chronic respiratory diseases,” said Ashley Ryan, manager of CRC program, primary health care. “We have had widespread success servicing patients virtually, however there is value in in-person testing to get a more accurate diagnosis. Once a patient has a proper diagnosis, we can then provide better, evidenced-based care. Being able to offer access to this service in the patients’ own community is the true mandate of primary care.”

The CRC team established a temporary testing clinic in Happy Valley – Goose Bay in collaboration with the local team to help reduce the waitlist for pulmonary functions, and also took the opportunity to meet with leadership and physicians in the zone to share information about the program.

Erin Ballah, director of primary health care and chronic disease prevention and management, is a strong supporter of this collaboration.

“Partnerships across different programs and zones allow our organization to meet our strategic objectives of quality, access and health equity. The passion of this small but mighty team and the welcoming approach of the Labrador residents, clients and staff have made this an outstanding success, and a model to be replicated across all chronic disease management in our province. This is a true example of reducing barriers and bringing care closer to home.”

Two respiratory therapists from the CRC team, Amy Sweeney and Christine King, also travelled to Nain and Hopedale to collaborate with the local health-care teams to offer testing clinics and education. The collaboration was a huge success and benefited more than 55 patients between the three sites.

“This partnership demonstrates how collaboration among teams not only positively contributes to patient outcomes, but enhances job satisfaction of our employees and promotes both professional and personal growth,” said Ashley.

“The CRC collaboration has been an outstanding success – starting with virtual clinics and expanding to in-person care, it has transformed how we connect and care for our patients. It has not only improved patient outcomes but also deepened our knowledge as health-care providers, empowering us to better educate and support those we serve,” said Emily MacFarlane, regional nurse at the Nain Community Clinic.  
Not only did the CRC team have the opportunity to work with the staff and patients at the clinics, but the communities welcomed the team with open arms and provided them with opportunities to truly experience life in Labrador.  

“I’m deeply grateful to have had the chance to contribute, in whatever way possible, to the respiratory health and well-being of the residents in Nain and Hopedale,” said Christine. “I’m equally grateful for the warm and enthusiastic welcome we received from the clinic staff, patients, and all the other friendly faces we encountered.”  

“We came to offer support but left deeply inspired by the sense of community and collaboration. It was an honour to work alongside the local teams and contribute in a way that was valuable to patients,” said Amy.  

Bringing the vision to life

Expanding respiratory care in rural and remote areas aligns closely with NL Health Services’ vision and strategic priorities.

According to Dr. Vidyasankar, the program’s medical director, and division head of Respirology with NL Health Services: “Ultimately, initiatives like what’s being done with the comprehensive respiratory care program are a critical step toward closing the health-care gap for rural and remote populations and ensuring health equity no matter where you live within the province.”