Background
Emergency Department (ED) overcrowding leads to delays in care and substandard healthcare delivery. Individuals admitted to an overcrowded ED, have increased risk of mortality in the following 10 to 30 days. There is no single cause of ED overcrowding; however, frequent ED use is one contributing factor. Across the province, roughly 13% of visits to the ED are attributable to individuals who use the ED frequently (6 or more times per year), and 2% of visits are attributable to super users (20 or more visits per year). In addition to contributing to overcrowding, frequent ED use also can result in provider bias/burnout and can cause harm to the patient. Frequent use can also be a symptom of poor access to other means of healthcare.

Studying the frequent ED user population is complex due to variability in the definition of a frequent user (definitions range from 6 – 20+ visits in a 1-year period) and variability in diagnoses/reasons for visiting the ED. Additionally, some individuals have an acute period of frequent use which resolves while others become chronic frequent users. Local interventions for frequent users have been piloted with some success; however, they are very resource intensive. As a result, identifying frequent user populations and being able to predict individuals at risk of becoming a chronic frequent user early in their course for intervention is extremely important.

For these complex patients, it will be essential to understand reasons for ED use such that patient needs and priorities can be addressed in the development of tailored resources. Based on work in inpatients by members of our team, we expect several groups to be identified in the clustering analyses (Objective 1). We will identify three priority frequent user groups through a nominal group technique (Objective 2) to focus on for qualitative assessment (Objective 3) to compare and contrast antecedents of frequent use and lay the groundwork for targeted intervention development.

Roles and Responsibilities
We are asking for patient partners with lived experience of Emergency Department use in Alberta to be part of a steering committee to oversee the research project. Specifically, we would like patient partners to contribute to oversight of research activities -such as organizing forums, developing survey questions, assisting in the interpretation of research findings, and identifying possible interventions.
This opportunity can be virtual.

Time Commitment
The project is anticipated to begin November 1, 2025 and will span 3 years (2028). We ask patient partners to commit to one year with the option to renew for the additional years. Patient partners can be expected to engage in monthly meetings (~1 hour) that will be held in person in Calgary with a hybrid option available to encourage patient partners from outside of Calgary to join.

In addition to the monthly meetings, there will be materials to review throughout the course of the project.

Compensation
Compensation will be offered retrospectively pending Canadian Institutes of Health Research (CIHR) funding.

For further information or to apply

Jessica Holodinsky
Jessalyn.holodinsky@ucalgary.ca

OR

Megan Harmon
megan.harmon@ucalgary.ca