Grant: Project Grant

Researchers at the University of Calgary's O'Brien Institute for Public Health have partnered with the Calgary Urban Project Society (CUPS), a community health centre, Alpha House, a shelter and housing agency, and Alberta Health Services to evaluate the Connect 2 Care (C2C) intervention for socially vulnerable patients. C2C is a mobile outreach team, co-managed by CUPS and Alpha House, that is comprised of nurses and health navigators and provides transitional case management for patients who are homeless or unstably housed and have high use of the emergency department and hospital services. The team receives referrals from emergency departments, hospitals and community partners such as shelters, and acts as a bridge to help patients navigate primary care, mental health care, addiction treatment, social agencies, housing and other programs. The University of Calgary team is evaluating the C2C program to understand its structure, processes and outcomes, as well as contextual factors that influence its success. We are measuring the health care system use and health status of referred patients, as well as exploring patient, team and partner experiences with the program. While a preliminary evaluation is underway, CIHR funds will facilitate a more comprehensive understanding of the key elements of the program, how it works and whether it works to improve outcomes for socially vulnerable patients. This partnership is expected to improve community-based care. Our work will support program sustainability and spread to other urban settings (both within Alberta and beyond) to improve care quality and efficiency for socially vulnerable patients.