Pilot project helps Montreal children get care closer to home
Posted May 15, 2025 1:47 pm.
Last Updated May 15, 2025 4:09 pm.
As respiratory viruses fill hospital wards each winter, pediatric hospitals like Montreal Children’s Hospital and CHU Sainte-Justine often face crowded emergency rooms and high patient numbers. However, not all young patients need specialized care, and a new pilot project aims to change that.
The initiative redirects some pediatric patients to community hospitals with pediatric expertise, helping children receive care closer to home and easing the pressure on larger hospitals.
The project is already in place at Hôpital Maisonneuve-Rosemont in Montreal and Hôpital de la Cité-de-la-Santé in Laval, with plans to expand to six more locations.
By March 26, over 180 patients had been transferred to pediatric day hospitals in their own communities.
The focus is on conditions that need follow-up but not full hospitalization, such as urinary tract infections, cellulitis (a bacterial skin infection), and ear infections that require antibiotics. These patients are sent to “day hospitals” where they can be monitored during the day and return home at night.
To make coordination easier, a shared online platform connects hospitals and simplifies patient referrals.
How the pilot project came about
Dr. Helena Evangeliou, pediatrician and medical director at Montreal Children’s Hospital Day Hospital, explained the initiative was born out of a health-care crisis.
“This project really came to be out of a kind of crisis situation in the fall of 2022, when pediatric hospitals in Montreal were hit with a triple viral surge of COVID, RSV, and influenza.
“We’re brainstorming ways that we can offload certain patients to community hospitals.”
Dr. Evangeliou highlighted how the collaboration between Montreal Children’s Hospital and Sainte-Justine helped make the project possible.
“We actually joined forces, realizing that we were trying to achieve the same goal.”
Benefits of care closer to home
One of the key benefits of this initiative is that it reduces the stress of travelling for families with sick children.
“You can imagine a family who’s getting little sleep with a sick child at home, the last thing they want is to worry about a very busy and lengthy commute into the big city, which may involve daily visits for a certain number of days. So, these children are able to rest for prolonged periods of time at home,” Dr. Evangeliou expressed.
She highlighted that many families are unaware of nearby pediatric care, and that the positive experience has encouraged hopes for future growth and increased consultations.
“The hope as well is that as these families are familiarized and have positive experiences in the pediatric day centers closer to their home, they’ll be more likely to seek care in those centers as well the next time around. And then ultimately we can expand our network of pediatric care in the community.”
Positive feedback from health-care providers
Feedback from both health-care professionals and families has been very positive.
“We initially started the project with Cité-de-la-Santé and Hôpital Maisonneuve-Rosemont. Based on the positive feedback received not only from the health-care professionals at these centres but also from the families we interviewed, we’ve decided to expand to other centres on both the north and south shores of Montreal,” explained Dr. Evangeliou.
Nathalie Gélinas, manager of pediatric care at Hôpital de la Cité-de-la-Santé, shared that the project has had a great impact on local families.
“Just to be closer to home, decrease the stress of driving downtown, going to CHU Sainte-Justine or Montreal Children’s, and ease all the stress for the parents,” she said.
“Now, we are seeing families from Montreal Children’s, which we didn’t have before. We used to only have parents from the children at Sainte-Justine.”
Personalized care for each child
One unique aspect of the care provided at community hospitals is the personalized attention given to each child.
“What we have, the good thing about this day care unit, is that we have only two stretchers and one nurse who is always here to take care of those children. So, most of the time, it’s one-to-one or one-to-two, which you cannot see or have at the tertiary center because it’s bigger units. So, that’s one of the advantages,” said Gélinas.
Coordinating care between hospitals
Martin Reichherzer, clinical-administrative coordinator at Sainte-Justine, explained that the project required smooth coordination between hospitals to ensure patients received the same level of care.
“The fact that we collaborated with Sainte-Justine and the Children’s Hospital was really a key factor in this project. Both pediatric hospitals in Montreal faced the same issue. The collaboration of our efforts in this project was truly instrumental because we see the same patients. The same parents come to us with their sick children, and it’s a reflex for many of them. When they need further care that doesn’t necessarily require the specialized services provided by Sainte-Justine and the Children’s, they can go back to the secondary hospitals on the periphery of Montreal for their follow-up care.”
Reichherzer also described how the patient referral process was standardized to improve efficiency.
“What we did was use a common online platform to standardize the way we refer patients, which streamlined the whole process for everyone by having a consistent approach.”
Looking to the future
The goal is to continue expanding the network of pediatric day hospitals across Quebec, helping to reduce overcrowding in larger hospitals and offer more care options in communities.
“I would just like to say that we are extremely proud of this initiative,” said Dr. Evangeliou.
“I think one of the most unique aspects is the collaboration we’ve been able to establish between Sainte-Justine and Montreal Children’s Hospital. We’ve developed a concerted effort, which I believe is the main strength of the project. We continue to meet regularly to ensure the safety of the project and troubleshoot any issues. And we’re not done thinking big for this project — I believe there’s a lot of potential for it to expand to other areas of the hospital. I think this success is really due to the close working relationship between the two pediatric hospitals in Montreal.”
