Clinical Activity

Our Clinical Community | Viral Surge | 2023 E. coli Outbreak | Outreach Activity | In the News

The Department of Pediatrics is comprised of more than 300 clinical members who provide expert pediatric and subspecialty care for a catchment population of approximately 2.5 million, ranging from extremely preterm infants to adolescents transitioning to adult care.

In November 2022, the Alberta Children’s Hospital began seeing unprecedented volumes of children presenting to the emergency department. In addition to the huge increase in patient numbers, there was also a marked increase in how sick these children were – mostly driven by respiratory viruses – and how many were needing admission to hospital. 

The MASSS initiative succeeded in quickly ramping up capacity to manage the higher volumes, enabling teams to flow these patients through the hospital. "Once we had the space and the people, we were able to get up and running very quickly and start admitting these patients," says Dr. D'Mello. "Together, we really met our goal of being able to move patients out of emergency department quickly and flow them through the hospital, discharging them as soon as they were ready to go home so we had space available for the next patient." 

The response to the viral surge illustrated the importance of a supportive and collaborative team environment in a challenging and unprecedented situation. Our hospital pediatricians were very appreciative to have extra support in caring for the admitted patients and were incredibly receptive and helpful in ensuring the nurses and physicians who weren’t accustomed to caring for inpatients were comfortable, well-prepared and supported. There were a lot of great relationships made between the nurses – the majority from Rotary Flames House – and the physicians on service. Our emergency physicians, subspecialists, and community pediatricians were also very eager to help and collaborate as a team. “We were able to establish great connections between different groups from the hospital and community who don’t normally get to interact, at least not directly,” says Dr. D’Mello, the Medical Co-Lead for MASSS together with Dr. Kristin Evashuk from the Section of Community Pediatrics. “The families we cared for seemed very appreciative of how much extra effort everyone was putting in. While they were going through something difficult, they remained positive and saw that people were doing their best to come together in a very busy situation."

We would like to extend a huge thank you to the following physicians who volunteered for MASSS shifts:

From Pediatric Emergency Medicine: Drs. Jenn D'Mello (Medical Co-Lead for MASSS), Russ Lam, Jennifer Thull-Freedman, Naminder Sandhu, Shirmee Doshi, Ellen Morrison, Shabnam Minoosepehr, Michelle Simonelli, Kelly Millar, Jonathan Guilfoyle, Lundy Day, Heather Patterson, Gavin Burgess, Kelly Millar, Ed Les, and Antonia Stang. 

From Community Pediatrics. Drs. Kristin Evashuk (Medical Co-Lead for MASSS), Natalie Forbes, Syeda Abbas, Jen MacPherson, Desiree Yow, Ian Frankish, Carrah Bouma, and Alex Carter.

From Rheumatology: Dr. Susa Benseler

There were many other physicians from the Sections of Pediatric Emergency Medicine, Community Pediatrics, and Pediatric Hospital Medicine who volunteered to staff shifts but didn't end up doing so as the MASSS unit was able to close earlier than anticipated once the viral surge tapered off.

In the fall of 2023, the Alberta Children's Hospital (ACH) responded to an unprecedented E. coli outbreak affecting children in the Calgary Zone, impacting our ACH emergency department, inpatient, and ambulatory areas of the hospital. 

On September 5, 2023, ACH clinicians realized we were facing a significant issue, meaning all children who had come in with bloody stools would require follow up and daily bloodwork to rule out Shiga toxin-producing E. coli (STEC) infection until they had fully recovered. 

By the following day, a clinic was running in the Infectious Diseases space with extra staffing in place. It quickly became apparent that the space was too crowded - with between 50-80 children needing to be seen daily - and teams decided to move the clinic space to the conference room area of the hospital. By Friday, September 8, the conference rooms were set up as a fully functioning clinic with laboratory services, Child Life Specialists, nursing and physicians, complete with movies to occupy the children and volunteer services to help hand out snacks. The conference room clinics ran for about a ten-day stretch. 

Establishment of the STEC Clinics was an incredible effort from our ACH operations team, with significant leadership from Drs. Stephen Freedman (international STEC/HUS expert and pediatric emergency physician), Silviu Grisaru (Section Chief, Pediatric Nephrology), Tania Principi (Section Chief, Pediatric Emergency Medicine), Antonia Stang (Department Head, Pediatrics), Sidd Thakore (Pediatric Follow Up Clinic Lead), and Otto Vanderkooi (Acting Facility Medical Director and Section Chief, Pediatric Infectious Diseases). The clinics were staffed largely by emergency physicians, pediatric hospital medicine physicians, and community pediatricians. The establishment of new clinics both in the infectious diseases clinic space and the conference rooms had huge operational requirements requiring (and receiving) huge support and leadership from ACH Operations Natasha Tiemstra (Executive Director, Ambulatory Care) and Jill Woodward (Acting Senior Operating Officer), with dedicated project leadership from Shauna Langenberger (Quality Consultant). Many additional leaders at every level of the organization stepped up to make these new clinics possible. The collaboration between all teams was an incredible testament to the strong relationships and dedication to child wellness for all who were involved in managing the outbreak at ACH and beyond. 

"The human factor was huge, and everyone went above and beyond to help," explains Dr. Otto Vanderkooi. "The can-do attitude was absolutely amazing, from our senior operations leaders all the way across the spectrum of medical and allied health. We had everyone asking, 'How can I help? What can we do?"

The outbreak affected more than 1000 individuals across the Calgary Zone. The Alberta Children's Hospital saw 439 cases, of which approximately 350 were confirmed positives for E. coli. 33 patients were admitted with STEC infection or HUS, 23 patients were confirmed to have HUS, and 8 required dialysis. Every child who was potentially exposed to E. coli was tested, and every child who tested positive for E. coli was followed with daily bloodwork so that HUS could be identified as early as possible. "The resiliency of our patients and their families was really remarkable," says Dr. Vanderkooi. "It was a 10-day journey at a really high stress level, that ended with tons of smiles and high fives when children were discharged."

The response to the outbreak was yet again an incredible collaboration between a vast number of different teams, including but not limited to our ACH operations team, nursing, lab services, housekeeping, volunteer services, Child Life Specialists, as well as the Sections of Pediatric Emergency Medicine/Pediatric Infectious Diseases/Pediatric Nephrology/Pediatric Hospital Medicine and other subspecialty teams who stepped up to staff the ad hoc clinic and support each other on the inpatient side. "The human factor was huge, and everyone went above and beyond to help," explains Dr. Otto Vanderkooi. "The can-do attitude was absolutely amazing, from our senior operations leaders all the way across the spectrum of medical and allied health. We had everyone asking, 'How can I help? What can we do?"

The outbreak affected more than 1000 individuals across the Calgary Zone. The Alberta Children's Hospital saw 439 cases, of which approximately 350 were confirmed positives for E. coli. 33 patients were admitted with STEC infection or HUS, 23 patients were confirmed to have HUS, and 8 required dialysis. Every child who was potentially exposed to E. coli was tested, and every child who tested positive for E. coli was followed with daily bloodwork so that HUS could be identified as early as possible. "The resiliency of our patients and their families was really remarkable," says Dr. Vanderkooi. "It was a 10-day journey at a really high stress level, that ended with tons of smiles and high fives when children were discharged."

Providing subspecialty services to children, youth, and families across southern Alberta
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