Memorandum

Date:

January 6, 2015

To:

All Staff and Physicians, Addiction & Mental Health Edmonton Zone

From: Mark Snaterse, Executive Director, Addiction and Mental Health Edmonton Zone
Dr. Pierre Chue, ZCDH, Addiction and Mental Health Edmonton Zone
RE:

Direct Presentations to Alberta Hospital Edmonton

In response to increasing concerns related to the safety of the small number of patients who
present directly to Alberta Hospital Edmonton, we have decided that direct patient presentations
to AHE will be discontinued.
This change will come into effect on February 8, 2016. This decision has been made after much
thought and consideration, and numerous conversations with staff, physicians and leaders at
both AHE, and at our Emergency Departments across the Edmonton Zone.
The decision to end direct patient presentations at AHE is being made for purely patient safety
reasons. Increasingly, patients are presenting to AHE with complex undiagnosed medical comorbidities that have included overdose, head injury, cervical fractures, metabolic disorders,
neurological disorders and unstable cardiac conditions.
A growing percentage of patients who currently present directly at AHE require transport (often
by ambulance) to an Emergency Department, due to the fact that AHE does not have the
medical supports necessary for assessment and stabilization.
Over the past year, there have been increasing concerns pertaining to safety, many of which
have been voiced by our AHE psychiatrists who receive these patients upon presentation.
Several Quality Assurance Reviews into close calls have been undertaken and those reviews
consistently recommend that steps are taken to curb direct presentations to AHE. Currently,
AHE is the only stand-alone psychiatric facility in the province that accepts direct presentations.
It is acknowledged that this change will result in a small increase of 1-2 additional mental health
presentations distributed amongst our four designated emergency departments (University of
Alberta Hospital, Royal Alexandra Hospital, Misericordia Community Hospital, and Grey Nuns
Hospital) each day. We recognize this, but still support the change due to the positive impact
on patient safety.
This change does not impact any other programs at AHE. Patients will continue to be
transferred into AHEs acute beds after they have been medically cleared and admitted by a
consulting psychiatrist.

Addiction and Mental Health - Alberta Health Services - Edmonton Zone

th
108 Street Building, 6 Floor, 9942 - 108 Street Edmonton AB T5K 2J5
www.albertahealthservices.ca

This change is coinciding with changes that will also be made to our historical take day
system, which directs our mobile crisis team and out-of-zone referrals through RAAPID to a
specific site based on the day of the week.
It is recognized that, regardless of our plans, some patients and families may still come directly
to AHE seeking help. When this occurs, they will be greeted by a triage/navigation nurse,
assessed and directed individually according to their care needs.
Depending on individual scenarios, options may include a referral and warm hand-off to our
mobile crisis team, urgent psychiatric clinic, walk-in clinic, community supports, etc. or, in some
instances, transferring to an emergency department via EMS if it is required.
Please let us know if you have any questions about this upcoming change.

Addiction and Mental Health - Alberta Health Services - Edmonton Zone

th
108 Street Building, 6 Floor, 9942 - 108 Street Edmonton AB T5K 2J5
www.albertahealthservices.ca