Canada's emergency departments are drowning in demand, and Toronto General Hospital's groundbreaking approach to managing patient volumes offers a blueprint that could transform care across the country—including in Alberta.
The numbers tell a stark story. Toronto General's emergency department was designed to handle 20,000 patients annually. Today, it's treating 60,000 to 70,000 patients per year—more than triple its intended capacity.
"We've reached a breaking point," says Dr. Erin O'Connor, head of the emergency department at University Health Network's Toronto General. "This department was built for 20,000 and we're seeing 60,000-70,000 patients per year. Being located downtown comes with its own unique challenges related to mental health and homelessness, which compounds the problem."
Rather than accept defeat, Toronto General has pioneered what healthcare leaders are calling "care pathways"—strategic partnerships with other hospitals and specialized clinics designed to divert patients away from the emergency department when appropriate and speed up treatment for those who do arrive.
The Partnership Model That Works
The hospital has established partnerships with Women's College Hospital, a virtual emergency department, and Princess Margaret Urgent Care Clinic, which handles imaging and bloodwork without requiring a full ED visit. A mental health and substance use care pathway is currently in development with CAMH and the Ministry of Health.
Michael De Wit, nurse manager of the ED, says the model is fundamentally changing how emergency medicine works. "We have to constantly innovate and work on new models of care delivery in order to meet the challenges," he explains. "We try things. We say, let's fail fast. We brainstorm solutions with our frontline team and put them into practice."
One of the most effective innovations is rapid follow-up care. Instead of keeping patients admitted overnight, Toronto General now schedules next-day appointments before patients leave the ED. "They get to go home and sleep in their own bed," O'Connor says. "They don't have to stay in a hospital and we can move patients through and see the next person."
Why This Matters for Alberta
Alberta's emergency departments—particularly in Calgary and Edmonton—face similar pressures. The province's rapid population growth has strained healthcare infrastructure, making efficient models like Toronto General's increasingly urgent.
The hospital's approach also includes careful management of patients with complex needs and substance use issues, addressing withdrawal symptoms in the ED and connecting patients to appropriate outpatient and inpatient supports. This integrated approach reduces hospital stays and improves outcomes.
Dr. O'Connor acknowledges that despite these innovations, resources sometimes fall short. "We've made a number of adjustments to try to ensure that people are not waiting a long time, but it sometimes does outstrip our resources," she says.
The takeaway for Canadian healthcare administrators is clear: partnerships, innovation, and frontline input are no longer optional—they're essential to keeping emergency departments functioning.
This article is based on reporting from CBC Health. Original story by Talia Ricci, CBC News, April 26, 2026. Read the full CBC report.