Middle ground

A few people sit on colourful chairs next to floor-to-ceiling windows. They’re waiting to be seen in the urgent care department at the Sheldon M. Chumir Health Centre, just south of downtown Calgary.

Urgent care facilities – with staff trained in emergency care, laboratory services, diagnostic imaging, pharmaceutical dispensaries, intravenous therapy, cardiac monitoring and resuscitation care – help people who need more than a visit to their doctor’s office or a walk-in clinic but don’t need emergency care.

In the next year, more than 160,000 people are expected to visit Alberta’s five urgent care centres: the Chumir, South Calgary Health Centre, Okotoks Health and Wellness Centre, Airdrie Regional Health Centre and Health First Strathcona in Sherwood Park.

“We see a lot – orthopedic injuries, minor trauma, lacerations,” says Dr. Mike Spady, the medical director of Urgent Care at the Chumir, which opened in 2008. 

“We saw a large volume of flu patients during H1N1 and assisted in the regional influenza response. Really, there is no typical problem or typical type of patient that we see.”

At the Chumir, patient demographics vary from seniors and young people who live in the neighbourhood, to homeless people and CEOs who work in nearby office towers. About 150 patients come through the doors every day, and five or six arrive by ambulance.

Patients do not stay overnight at most urgent care centres and the hours of operation vary across the province.

Yet urgent care centres play a key role in reducing stress on emergency departments.

“In our busy emergency departments, there is a constant flow of patients who need immediate intervention, so patients who are less overtly unwell can sometimes wait many hours because the sicker patients must be attended to first,” Spady says. “Patients who are stable but have a potential medical issue that needs to be addressed within 12 to 24 hours can often be treated at an urgent care centre instead.”
 
Like an emergency department, everyone who arrives at urgent care is triaged using the Canadian triage acuity scale.

“Level 1 is immediate, life-threatening illness or cardiac arrest, you’re dying and you need immediate resuscitation. Level 5 is you might need a prescription refilled,” Spady says. 

“We focus on Level 3 patients – those who need attention within 12 to 24 hours – but obviously treat all other levels that arrive.”  

Alberta’s urgent care centres serve an important need, says Dan Marchand, provincial director, Urgent Care, Community and Rural, Alberta Health Services (AHS).

“We knew there was a gap between emergency departments and walk-in clinics or primary care offices,” he says. 

“AHS has done some studies where we measured people accessing emergency departments in a community before there was an urgent care department. We found a 22 to 25 per cent decrease in emergency utilization between the hours of operation of an urgent care centre.

“So you know it does work.”