Tuesday, May 29, 2018 • 10:15 - 11:45
Track Chair: Ms. Alexis Mageau
Room: TELUS 108-109

Coordinated Care for Vulnerable Populations with Complex Needs and High Acute Care Utilization - Dr. Van Nguyen and Dr. Kerry McBrien

Description: This presentation will describe the Connect 2 Care program in Calgary, which is a novel community-based partnership between Calgary Urban Project Society and Calgary Alpha House. This intervention targets vulnerable individuals with high acute care use with health care navigation and intensive case management to improve health outcomes and reduce systems use.

Learning Objectives:

  1. To describe system barriers faced by individuals living in poverty to access health and social supports.
  2. To describe the Connect 2 Care program as a collaborative community and acute care partnership to target complex individuals with high acute care utilization
  3. To present early outcomes data of the evaluation taken from qualitative interviews and administrative data.


  1. A collaborative approach involving community partners is needed to improve health outcomes and reduce emergency department visits.
  2. Vulnerable persons need a patient-centred approach to care that addresses the social determinants of health.
  3. Connect 2 Care is a novel intervention in Calgary that bridges transitions of care between hospital and community for complex individuals.

Biography: Dr. Nguyen is an inner city Family Physician and Health Director at Calgary Urban Project Society (CUPS), which provides health, housing and early education services to Calgarians living in poverty. She has an interest in improving population health outcomes for medically and socially complex individuals through care collaborations.

Biography: Dr. Kerry McBrien is an Assistant Professor in the Departments of Family Medicine and Community Health Sciences at the University of Calgary.  Her research focuses on the development and evaluation of models of care that can improve quality and efficiency of care for complex patients.

The Complex Care Hub: Thinking Beyond the Hospital Walls - Dr. Michelle Grinman and Mr. Ryan Kozicky

Description: Complex Care Hub is a partnership between Rockyview General Hospital’s acute medical services, the Community Paramedics, Home Care and Transition Services. An alternative to conventional inpatient admission, the CCH enables patients with low acuity issues requiring hospital-level interventions to be diverted from ED to receive care at home.

Learning Objectives:

  1. Importance of developing novel solutions to manage the health of Alberta’s ageing population
  2. Description of the Complex Care Hub model
  3. Lessons learned since the launch of the program


  1. It is imperative that we develop services to reduce the need for seniors to be hospitalized given their increased risk of complications, morbidity and mortality in hospital.
  2. Successful innovation requires a dynamic team able to continually challenge assumptions and find solutions in the face of uncertainty.
  3. Experiences from the frontlines of the Complex Care Hub.

Biography: Dr. Grinman is a General Internal Medicine Specialist with a special interest in health services research in the areas of improving access to services, transitions of care, and vulnerable populations. She has helped to found several initiatives aimed at improving integration of acute and primary care, particularly focusing on services for seniors.

Biography: The current Director for EMS Mobile Integrated Healthcare, responsible for the planning and implementation of Community Paramedic and EMS community support programs.  Previous education includes a B.Sc. Kinesiology, diploma in Paramedicine and a Masters of Public Health.

Medical Assistance in Dying: Personal Perspectives - Dr. Tom Rich and Ms. Evie Wallace

Presentation slides

Description: There continues to be a hesitancy for the medical profession to support MAID that very much differs from the support for MAID in the general public. We will explore the personal perspectives of a MAID provider as well as hear from Evie Wallace whose husband underwent MAID. We will explore the successful Calgary Zone MAID program and review the keys to the development and implementation of a successful program

Learning Objectives:

  1. MAID: Then and now. The Calgary Zone experience
  2. Keys to a successful program MAID program.
  3. Why ED physicians and nurses are ideal for the MAID program.


  1. MAID has come a long way (for some)
  2. Keys to a successful MAID program
  3. ED Physicians and Nurses are ideal MAID team members

Biography: Dr. Tom Rich, MD, CCFP-EM,FCFP

Physician: Department of Emergency Medicine

Associate Chief Medical Information Officer

Alberta Health Services, Calgary Zone

Clinical Assistant Professor, University of Calgary

MAID Assessor and Provider

Biography: Evie Wallace retired from Alberta Health Services 4 years ago after 35 years working in psychiatry as a nurse therapist.  Her husband Hugh was the first person in Alberta to have MAID.

Biography: Dr. Misty Watson, Medical Lead, Medical Assistance in Dying Calgary Zone

Site Lead, Rockyview Hospital Hospitalist Program

Biography: Lise Lalonde, Medical Assistance in Dying Navigator for the Calgary and Central Zones