Following the 2022–2023 pediatric viral crisis, the emergency departments and day medicine units at both of Montreal’s two tertiary care centres experienced severe overcrowding. Many of the children referred to these facilities didn’t require specialized care and often lived outside of Montreal.
CHU Sainte-Justine and the Montreal Children’s Hospital responded by implementing a joint initiative to redirect children in need of semi-urgent non-tertiary care to partner pediatric day medicine units. This approach is part of a departmental vision to provide the right care, in the right place and at the right time.
An analysis of the most frequent diagnoses identified three reasons for consults that could be managed in partner day medicine units in the Montreal area: ear infections, cellulitis and urinary tract infections. Two partner centres were mobilized first, followed by seven more in 2025, providing increased coverage across Greater Montreal.
The project is based on sustained interdisciplinary collaboration involving medical, nursing, administrative and technological teams. By standardizing practices, sharing clinical protocols, training teams and using existing tools (such as Microsoft Bookings, secure Outlook and an interactive map), we created a simple, fast and secure referral process with no additional technology investment.
Since the launch, over 450 children have been successfully redirected to partner facilities. This allows families to receive follow-up closer to home, reduce travel and access care more quickly. The teams have observed greater fluidity, enhancement of services offered by partners and optimized use of tertiary capacity. The initiative could easily be expanded and replicated in other regions.
Lead:
Martin Reichherzer, Clinical Administrative Coordinator
Contributors:
Dr. Helena Evangeliou, Pediatrician and Head of the Day Medicine Unit (UMDJ) at HME
Patricia Noel, Project Manager
Mike Chiupka, Emergency Administrative Officer
Samnang Bun, Head of the Day Medicine Unit
Kelly Cummins, Head of the Emergency Unit
