People experiencing homelessness often arrive at the emergency room looking for more than medical care.
At the Royal Alexandra Hospital, Hope Mission health navigators embedded in the emergency department work alongside staff to connect patients with shelter, housing, and other supports once they no longer need medical care.
“A health navigator is basically a bridge—a connection between the hospital and Hope Mission,” says Thomas Ogigbah, who oversees the team.
The program launched in November. In its first five months, it helped more than 4,000 people connect with services upon leaving the hospital. For two-thirds of them, that included transport to one of Hope Mission’s emergency shelters.
“A lot of our clients go to the emergency department looking for supports and resources, and that’s not the best location for receiving that type of care,” says Beth Klingenberg, Hope Mission’s director of health services. “We wanted to be present to help clients who might feel lost in the system get back to the resources we know well in the community.”
For people trying to access supports, navigating a complex and constantly changing system can be difficult. Health navigators receive referrals from hospital staff and also connect directly with people in the waiting room.
For Thomas, that work often begins simply.
“It starts with a conversation. It’s really anything and everything to help.”
From there, navigators identify each person’s needs and outline next steps.
“There are shelter providers, housing agencies, food resources—there’s a lot going on, and it changes regularly,” Beth says. “The navigators stay aware of those changes and connect people to where they need to go.”
Knowing where to go is one step; getting there and connecting with the right person is another. A well-connected navigator can be the difference between a missed connection and a warm handoff.
“We know the staff in each department, so we can call ahead, confirm everything, and arrange transportation. The team ensures the person gets through the door and understands what happens next—whether that’s shelter intake or meeting with housing staff.”
- LISTEN: Navigating Care Beyond the ER (Hope Stories podcast on Apple and Spotify)
Hope Mission operates a shuttle that provides transportation between hospitals, shelters, and other key locations in downtown and west Edmonton. It also has a shuttle team dedicated to hospital connections.
“A staff member comes into the ER, accompanies the person, and then walks them into the shelter at the other end. It’s a one-to-one service, which allows for relationship-building and a smoother transition.”
The navigators are not diverting people who need hospital-level care from the emergency department. Instead, they support people who have been medically cleared or discharged.
“Nobody is being sent away,” Thomas says. “We’re making sure that when someone is done at the hospital, or doesn’t need to be there, they’re connected to a place where they can receive help.”
- Read more: Why shelters are integrating health care
The team has built strong relationships with hospital security, nurses, and social workers, who regularly refer patients to the navigators for connection to community supports.
“We hope we’re seen as a complement to the hospital—an additional resource. The ER is busy, and it’s not easy to keep track of all community supports,” Beth says. “If we can take that last step and help guide someone in the right direction, it allows hospital staff to focus on medical care.”