Sunday, May 26, 2019 • 15:00 - 16:30
Track 3 - The Role of Emergency Medicine in Health Systems Change: From Canary in the Coalmine to Catalyst for Change
Track Chair: Dr. David Petrie
Room: 109

Patient Outcomes and Inter-organizational Quality Improvement as a Driver of Systems Change - Dr. Brendan Carr

Description: As one of the leads in the SAEM consensus conference in 2010 on Integrated Networks of Emergency Care, to his experience as Director of the U.S. Department of Health and Human Services Emergency Care Coordination Center, Dr Carr has had experience in influencing and researching the role of Emergency Medicine in Systems Change. One of his current interests includes working with multiple stakeholders through the National Quality Forum to transform health systems by championing efforts to move from volume-based to value-based care. This discussion will use examples from those experiences to describe a path forward.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Understand the new paradigm of measurement sets and systems in contrast to individual measure-for-measure, and process-by-process quality improvement.
  2. Recognize the important role that Emergency Medicine can play in system transformation, given their placement at the crossroads of the system – from canary in the coal mine to catalyst for change.


  1. Quality at a systems level, can drive systems change – the whole is greater than the sum of its parts.

Brendan G. Carr, MD, MA, MS is Professor of Emergency Medicine & Associate Dean at the Sidney Kimmel Medical College of Thomas Jefferson University. He is residency trained and board certified in emergency medicine, fellowship trained in trauma & surgical critical care, and is an alumnus of the Robert Wood Johnson Foundation’s Clinical Scholars Program. Dr. Carr’s research focuses on understanding the relationship between system design and health outcomes. His work has been funded by the Agency for Healthcare Research & Quality, the Centers for Disease Control & Prevention, & the National Institutes of Health.

Rural Issues in EM System Design and Improvement - Dr. Tanya Munroe

Description: Sorry…but the ED is closed today…. How do we deliver dependable access to high quality emergency care to rural populations…thinking beyond the “ER”

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Understand the considerations in balancing the consolidation and distribution of EDs across rural regions in Canada.
  2. Understand the implications of system design on recruitment/retention challenges in rural EM.


  1. Regionalization 2.0 as one responsive, effective, and integrated network of Emergency Health care, with a common vision, a coordinated mission, and many access points.

Department head, Emergency Medicine, Northern Zone, NSHA
Assistant Professor, Emergency Medicine, Dalhousie University, Halifax NS

Paediatric Issues in EM System Design and Improvement - Dr. Shannon MacPhee

Description: Emergencies in children is a core component of emergency medicine and in fact, up to 80% of kids seen in EDs are outside of tertiary care paeds EDs. TREKK is an incredible made-in-Canada resource for all Emergency Physicians. This presentation will explore the potential to leverage TREKK as a prototype for improving access and quality of care at a systems level.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Understand the scope and potential of TREKK as a real-time decision-support tool.
  2. Recognize the larger potential of the “TREKK approach” to drive change at a broader systems level.


  1. Even though kids are just small adults, TREKK can help “adult EDs” to grow up.

Shannon MacPhee, MD, FRCPC (PEDS), PEM. Dr. Shannon MacPhee graduated from medical school at Dalhousie University in 1999. She did her Pediatric residency and Pediatric Emergency Medicine Fellowship at the Hospital for Sick Children. Dr. MacPhee was recruited to the IWK in 2005 and is currently an Associate Professor in the Department of Emergency Medicine. Dr. MacPhee served as Chief of Emergency Medicine at the IWK Health Centre from 2009-2018.

Transforming Emergency Care in the UK - Building 'The Road' and Pulling Down the 'Red Flags'! - Dr. Taj Hassan


Learning Objectives
At the end of this presentation, participants will be able to:

  1. To provide an overview of strategic initiatives by policymakers to manage increasing demand and complexity for urgent & emergency care.
    To describe RCEM’s role to improve quality of care delivered in the ED.
  2. To share the journey of how well ( or not!) we are doing to help influence positive change.


  1. Data is power especially when it can link to a media profile.
  2. Influencing is ideally done behind closed doors with the right quid pro quo equation.
  3. Investing College resources to have a major influence on policymakers & providers in improving health of ED staff and finding ways to value them is the top investment.

Dr Taj Hassan is a consultant in Emergency Medicine at the Leeds Teaching Hospitals NHS Trust and also President of the Royal College of Emergency Medicine (2016 – 2019). He has previously held posts at NHS Improvement as Associate Medical Director for Urgent & Emergency Care, national RCEM Lead for Ambulatory Emergency Care and co-author of the national Directory of Ambulatory Emergency Care, Vice President of the RCEM and was Director of eLearning at the College (2005-2012) leading on the development of the eLearning platform that is now RCEMLearning.