Show the Thing 10: Nova Scotia - Digital Innovation in Healthcare

This is part of a series of blog posts for Show the Thing. Hosted by Public Digital and supported by the Rockefeller Foundation, Show the Thing brings together government digital teams from around the world. In our tenth, and final session of the series, we heard from experts in Nova Scotia's Department of Cyber Security and Digital Solutions (CSDS) on their journey towards building a new digital onboarding service to help alleviate the province's healthcare gap.

Since the formation of the Nova Scotia Digital Service in 2019, the province has been on an ambitious journey to increase its digital capacity, build its reputation, and attract some of the nation’s top digital talent.

In May 2023, the newly-formed Department of Cyber Security and Digital Solutions (CSDS) was presented with a pressing challenge to support an initiative to increase the number of nurses in the province. Whilst the department covers the more traditional IT and digital functions, this work offered a unique opportunity to apply thinking, techniques and decision-making to a problem that would ordinarily have been outside of the scope of internet era ways of working.

With an untested team and a problematic onboarding process, and without the aid of new systems or technologies, the challenge was significant. We heard from two members of CSDS to explain how they tackled the situation: Gabrielle Kelly, Acting Director of Human Centred Service Design, and Erik Hermans, Senior Service Designer.

Addressing the healthcare gap

As with much of Canada, Nova Scotia has a shortage of medical professionals. To address this, the government announced the first licensing scheme to expedite international nursing applications. The regulatory change enabled nurses from seven nations to benefit from a fast-tracked application process reduced from a year to a matter of weeks. The move is intended to catalyse a 2-3 year drive to bring a high volume of Internationally Educated Nurses (IENs) into the province’s healthcare system.

CSDS provides IT and digital services for all of the provincial government, including non-clinical healthcare services. It was tasked with rethinking the process of user access provisioning in light of the uptick in IENs. Challenges included:

  • The onboarding process is manual and inconsistently followed across Nova Scotia’s four zones.

  • The IEN recruitment initiative needed to run concurrently with the existing hiring plan.

  • The team needed to move quickly; they had just a week-and-a-half to create a process for IT onboarding.

Applying digital ways of working

CSDS started by scoping out the process and requirements, ensuring that it built on precedents and learnings from other departments, allowing the team to move at speed.

Critical to success was forming a large multidisciplinary and cross-departmental steering group. This ensured that the process was informed - and the risks considered - from a variety of perspectives and that processes were designed by and for users.

The team were able to take an iterative approach, quickly testing hypotheses amongst themselves and being empowered to act decisively, with the confidence that their actions were endorsed by senior leadership.

To develop a robust and consistent approach, the team worked to map the onboarding process, ensuring that their iterations standardised the disparate processes and were captured in transparent, visual and reusable formats.

To implement effectively, IENs are being onboarded as monthly cohorts, allowing for refinements between cycles. They are also receiving the support of a new team who manage the submission process for IT onboarding tickets.

Transformative impacts

The onboarding of five cohorts of Internationally Educated Nurses (IENs) marks a substantial milestone. These professionals now benefit from timely access to necessary accounts and training. While this initiative has not directly reduced workloads, it has streamlined and standardised processes, offering greater visibility and consistency.

The success story of Nova Scotia's rapid adaptation to legislative changes is testament to the strength and agility of its digital infrastructure. This capability gives confidence to policymakers and decision-makers that the province is well-equipped to support and realise new digital initiatives swiftly and effectively.

The Department of Cyber Security and Digital Solutions (CSDS) has not only tackled an immediate challenge but also set new benchmarks for future work. As Nova Scotia continues its digital journey, this success story underlines the province's commitment to digital excellence and public service innovation.

Thank you from the Show the Thing team

As we conclude the final event of our 'Show the Thing' series, we want to offer our thanks to Gabrielle and Erik for sharing their insight. Their experiences and perspectives provided a fitting conclusion to this engaging and far-reaching series

Across the series, we have been privileged to connect with leaders and practitioners from across five continents. It has spanned diverse topics, from data and education to security and payments. At Public Digital, we have been consistently inspired by the depth of expertise and innovative approaches - as well as the passion - of our presenters and their teams. We set out with a mission to share expertise and develop global government capability by showcasing the platforms and services that are enhancing citizens' lives in various contexts worldwide. The great participation and positive feedback convince us that we have succeeded.

We extend our sincere thanks to the hundreds of participants who have listened and engaged with the series. Your involvement has been crucial to its success. We hope that you are all as inspired as we are, and can take forward new insights and ideas. We look forward to future collaborations as part of our global digital community.

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