Clinical Service

Inpatient Consultation Services
The Division offers consultation services to all acute-care facilities in Edmonton, including the University of Alberta Hospital, the Cross Cancer Institute, the Royal Alexandra Hospital and Glenrose Rehabilitation Hospitalthe Misericordia Community Hospital, and the Grey Nuns Community Hospital.
Outpatient Consultation Services
Timely consultations for a variety of infection-related problems are provided through the ambulatory care facilities at the regional acute care hospitals. A significant proportion of these consultations are for HIV/AIDS and for chronic viral hepatitis, and are coordinated through the Northern Alberta HIV Program and Hepatitis Support Program (see below).
Antimicrobial Stewardship Program

UAH/MAZ/KEC ANTIMICROBIAL STEWARDSHIP PROGRAM

Justin Chen, MD, FRCPC

Medical Director

Director of the Program since 2017
Phone: 780-492-8782
Fax: 780-492-8050

Other Key Participants in the Program:

Drs. Stephanie Smith and Karen Doucette, ASP pharmacists Cecilia Lau and Karen Fong

Program Description

The UAH/MAZ/KEC Antimicrobial Stewardship Program is a multi-disciplinary endeavour, collaborating with Provincial Laboratory for Public Health (Microbiology), UAH/MAZ/KEC Infection Prevention & Control Program, and UAH Pharmacy amongst others. A clinical inpatient service consisting of ID specialists and ASP pharmacists was established in 2018 to perform Prospective Audit and Feedback of high impact antibiotics. Over 500 antibiotic prescriptions are audited annually and optimized in real-time. UAH is also one of the primary sites for trainees in Infectious Diseases and Medical Microbiology to receive their Antimicrobial Stewardship rotation as per Royal College training requirements. Although the program is young, it is active in research with numerous presentations at academic conferences.

COVENANT HEALTH ANTIMICROBIAL STEWARDSHIP PROGRAM

Holly Hoang, MD FRCPC

Medical Director

Founder and Director of the Program since 2012
Phone: 780-735-7236
Fax: 780-735-9760

Other Key Participants in the Program:

  • Dr. Gordon Stewart (committee co-chair)
  • Dr. Shahileen Remtulla and Karen Zurek (antimicrobial stewardship pharmacists)
  • Chinenye Nwoke (epidemiologist)

Program Description

The Covenant Health Antimicrobial Stewardship Program provides Antimicrobial Stewardship (AS) oversight and services to the Grey Nuns and Misericordia Community Hospitals in Edmonton along with six rural acute care sites within the province of Alberta.  It is a multidisciplinary, accredited program that develops quarterly educational newsletters and performs audit and feedback on key infectious diagnoses (eg. C. difficile and S. aureus bacteremia) as well as a number of high impact antimicrobials.   With nearly 3000 audits annually, the program is instrumental in the optimization of patient care in real-time. The program is active in research activity with peer-reviewed publications and participation in academic conferences.  Educational activity includes the development of the Antimicrobial Stewardship Rotation for the University of Alberta Infectious Diseases and Microbiology rotating residents with the Grey Nuns Hospital functioning as the primary site.

Federal and Provincial Prison Clinics
The Division provides care to inmates with HIV, HCV and HBV infections in federal institutions in Northern Alberta (Edmonton Institution, Edmonton Institution for Women, Grande Cache Institution) and to adults in provincial correctional facilities across Alberta. The Division also provides assistance with treatment and follow up of STIs in provincial and federal correctional facilities and serves in medical leadership for Infection Prevention and Control in provincial corrections.   
Hepatitis Support Program

The Hepatitis Support Program (HSP) in Edmonton provides comprehensive care to Northern Albertans with hepatitis C and hepatitis B infections. Physicians from both Infectious Diseases and Gastroenterology & Hepatology participate in this program, with a Medical Lead representing each Division. There are six program nurses as well as a dedicated social worker and clerical staff for the program.

The Infectious Diseases Division accepts referrals from physicians, from other health care providers (e.g. nurse clinicians, public health professionals), and as self-referrals. The program has been operating since 2003, with an average of about 600 referrals yearly to the ID section.

Nurses triage referrals, coordinate baseline investigations prior to the physician visit, are trained in the non-invasive assessment of hepatic fibrosis using FibroScan®, and follow patients on antiviral therapy. Nurses and the social worker also provide education and counseling, including the need for vaccination against hepatitis A and B and as needed, harm reduction, and access to mental health and addiction services. After completion of baseline investigations, patients are seen by physicians at the University of Alberta and Royal Alexandra Hospitals as well as the Boyle McCauley Health Centre.

The ID Division is actively involved in clinical trials in viral hepatitis and potentially eligible patients are presented with the opportunity to participate as trials begin. The ID HSP also provides core training in viral hepatitis to our University of Alberta ID Subspecialty Residents and offers an elective rotation (generally 2-4 weeks) to other medical residents.

Medical Lead (ID):

Dr. Stephen Shafran
Division of Infectious Diseases
1-135 Clinical Sciences Building
Email: sshafran@ualberta.ca
Phone: 780-492-3319

Medical Lead (GI):

Dr. Winnie Wong
Division of Gastroenterology
1-24B Zeidler Ledcor
Email: winnie.wong@ualberta.ca
Phone: 780-492-8134

Program Secretary:

Wendy Thomas-Charway
3A1.05, Kaye Edmonton Clinic
Edmonton, AB T6G 1Z1
Phone: 780-407-1650
Fax: 780-407-8659

HIV Program

SHANNON TURVEY, MD, FRCPC

Director, Northern Alberta HIV Program

Program Description

The Northern Alberta HIV Program and its affiliates are the main source of care to all HIV-infected individuals in northern Alberta, currently over 2,500. The clinic population is highly varied, and we aspire to provide a welcoming environment to indigenous patients, immigrants and refugees, men who have sex with men and people who are street involved or use drugs.

A broad range of care and support, including antiretroviral therapy, is provided by a multi-disciplinary team working from two primary sites: the University of Alberta and Royal Alexandra Hospitals. Support around housing, substance use, partners and families, and reduction of HIV transmission are part of the team's mandate, depending on the individual patient's needs. The team includes nurses, social workers, pharmacists, psychologists and dietitians working with Infectious Diseases physicians with a special interest and expertise in HIV care. The program has a particular emphasis on the prevention of mother-to-child transmission of HIV. Antiretroviral drugs are provided to all patients with Alberta Health Care at no cost to the patient.

There are strong links with relevant community organizations including HIV Edmonton (the local AIDS service organization) and Streetworks (needle exchange and street outreach program). Several program members have been involved in international work. The Edmonton Sexually Transmitted Infections Clinic and the inner-city Boyle McCauley Health Centre are closely affiliated with our program. We have links with northern communities such as Fort McMurray and Grande Prairie to facilitate care for patients who live far from Edmonton. Our staff also provides outreach services to local correctional facilities, and the local HIV patient residence, Kairos House.  The ACE team is a unique resource which provides intensive medication adherence and other supports to patients with particularly complex needs. Team members are involved in a broad range of research activities including trials of new drugs and epidemiologic studies.

Infection Control

Stephanie W. Smith, MD, MSc, FRCPC

Medical Director, University of Alberta Hospital and Stollery Children's Hospital Infection Control Unit

Uma Chandran, MD, MPH, FRCPC

Medical Director, Infection Prevention and Control, Royal Alexandra Hospital, Glenrose Rehabilitation Hospital & Suburban Hospitals Edmonton Zone

Alexandra McFarlane MD, FRCPC

Associate Medical Director, Infection Prevention and Control, Sturgeon Community Hospital

Other Key Participants in the Program:

Dr. Bonita Lee

Associate Medical Director (Stollery Children’s Hospital), Beth Wilke Administrative Director

PROGRAM DESCRIPTION

Infection Prevention Services provides expertise and support to meet the needs of all individuals associated with the Royal Alexandra Hospital, with regard to the prevention of healthcare-associated infections. The program also interacts with national and international Infection Prevention programs. The primary goal of Infection Prevention Services is to promote patient safety by minimizing healthcare-associated infections. Infection Prevention Services personnel provide expertise in epidemiological methods of investigation and current cost-effective interventions. Their scope of activities includes the following:

  1. Policy & procedure formulation.
  2. Education.
  3. Consultation with medical staff, hospital staff and administration.
  4. Surveillance (prospective-inpatient, and post-discharge).
  5. Collaboration with Public Health Regional Infection Prevention & Control Program.
  6. Investigation of outbreaks.
  7. Reporting of notifiable diseases to appropriate authorities.
  8. Research.
  9. Product evaluation.
  10. Collaborate with Occupational, Health Safety & Wellness.
  11. Initial advice to/follow-up and risk management of potentially exposed patients.
  12. Advice/Infection Control Expertise and participation with Hospital Redevelopment Projects.
Occupational Infectious Diseases

Provincial Communicable Disease Physician Consultant

Alberta Health Services (AHS), Workplace Health & Safety (WHS)
Robyn Harrison MD MSc FRCPC (2009 – present)

Program Description:
The Alberta Health Services Workplace Health and Safety program aims to provide the highest standards of prevention and management for potential occupational hazards or exposures including communicable diseases for over 117,000 healthcare workers province-wide.
Dr. Harrison’s role is to help facilitate effective and efficient prevention and management strategies for infections that may be encountered in the healthcare workplace. Dr. Harrison actively participates in the development of guidelines, policies, and procedures for the provincial team. These guidelines relate to baseline healthcare worker assessments and vaccinations, and they also provide guidance for the management of potential exposures or outbreaks from a myriad of infectious agents.
Some examples of potential infections include bloodborne pathogens such as HIV, hepatitis B, and C; respiratory pathogens including but not limited to Influenza viruses, Tuberculosis, Measles, Varicella zoster virus; and bacterial pathogens such as Group A Streptococcus species, Pertussis, methicillin-resistant Staphylococcus aureus and many more.
The provincial WHS team also responds to emerging and potential pathogens including but certainly not limited to novel or avian influenza viruses, coronaviruses, or hemorrhagic fever viruses.
Dr. Harrison’s work is collaborative with the WHS physician, nurse, and administrative team members; and also with Infection Prevention and Control and Public Health partners. Addressing infection prevention and management are areas of active and ongoing collaboration.


Communicable Disease Physician Consultant

Occupational Health and Safety (OHS), Covenant Health (CH), Edmonton zone
Curtiss Boyington MD FRCPC September 2014-2018, Edmonton Zone, 2018-present, Provincial
Program Description:
The Covenant Health Occupational Health and Safety Program aims to ensure healthcare worker safety in the workplace. As such, communicable disease prevention is an important part of the program. The Infectious Disease consultants (Dr. Robyn Harrison 2008-2014; and Dr. Curtiss Boyington 2014 – present), aim to facilitate education, guidance, consultation services, and policy and procedure development as they relate to communicable diseases. This work includes pre-employment communicable disease health assessments, provision, and promotion of healthcare worker vaccinations; prevention, and management for healthcare workers after potential communicable disease exposures including (although not limited to) blood and body fluid exposures. The communicable disease consultants also provide outbreak management support and assist in addressing potential exposures to rare or emerging pathogens in the workplace.
OPAT Services

PROGRAM DESCRIPTION

The Outpatient Parenteral Antimicrobial Therapy (OPAT) clinics provides intravenous antimicrobial therapy and follow up care to ambulatory patients, with consultative support and oversight from members of the Division of Infectious Diseases at multiple sites in the Edmonton Zone. Patients are referred from community physicians and hospital services and accepted based on referral criteria. The clinic not only provides patients with timely access to Infectious Diseases expertise and continuing care but also serves to alleviate congestion in the Emergency Departments and facilitate early discharge from Inpatient Units. The clinic facilitates medical education (both undergraduate and postgraduate), providing learners the opportunity to diagnose and manage common outpatient infectious disease syndromes.

Infectious Diseases Led OPAT Sites

  • Royal Alexandra Hospital, Outpatient IV Clinic
    Medical Director, Dr. Isabelle Chiu
  • University of Alberta Hospital, OPAT Clinic
    Medical Director, Dr. Karen Doucette
  • Grey Nuns Hospital, IV Clinic
    Medical Director, Dr. David Waldner

OPATs Supported by On-Site ID Consultation

  • Misericordia Community Hospital, IV Therapy Clinic
  • Strathcona Community Hospital, IV Therapy Clinic
  • Sturgeon Community Hospital, IV Clinic
  • Northeast Community Health Centre, IV Therapy Clinic
Transplant Infectious Diseases

CARLOS CERVERA, MD, PHD

Medical Director, Transplant Infectious Diseases

Other Key Participants in the Program

  • Karen Doucette, MD, MSc, FRCPC
  • Dima Kabbani, MD, Program Director
  • Catherine Burton, MD
  • Ilan S. Schwartz, MD, PhD
  • Wendy Sligl, MD

Program Description

The Transplant Infectious Diseases program is the largest such program in Western Canada. It provides in-ward consultation to the Multi-Organ Transplant program and the Cross Cancer Institute. In addition, the program provides pre-transplant evaluation for complex cases and follow-up of infectious complications in the outpatient clinic. The Transplant ID program is actively involved in basic, translational, and clinical research as well as providing clinical and research training. This group is also actively involved in Master and PhD graduate studies. We offer a 1-2 year Transplant ID fellowship program as well as shorter (1 month) electives in Transplant ID for interested trainees.

Travel Medicine

The Tropical Medicine & Parasitic Infections clinic serves as an avenue for evaluation, diagnosis, and management of infections in returning travellers (especially from tropical areas), as well as evaluation and management of all parasitic infections.  Offered at the Kaye Edmonton Clinic (University of Alberta Hospital), this clinic is staffed by physicians of the Infectious Diseases Division with specialised training and certification in the area of Tropical Medicine and Travel Health.  The physicians that currently participate in the Tropical Medicine & Parasitic Infections Clinic include:

  • Jamil Kanji, MD, DTM&H, FRCPC, Clinic Director
  • Robyn Harrison, MD, MSc, FRCPC
  • Stan Houston, MD, DTM&H, FRCPC
  • Dennis Marion, MD, DTM&H, FRCPC
  • Lynora Saxinger, MD, CTropMed, FRCPC
  • David Waldner, MD, DTM&H, FRCPC
Tuberculosis Program

DENNIS KUNIMOTO, MD, FRCPC

Medical Director, Edmonton TB Clinic, Edmonton Tuberculosis Program
Director of the Program since July 1999

Aberhart Center
9232 - 11402 University Ave
Edmonton, Alberta, Canada  T6G 2J3
Phone: 780-407-4550
Fax: 780-407-7637

Other Key Participants in the Program:

Drs. Rabia Ahmed, Ryan Cooper, Vivek Dhawan, Giovanni Ferrara, Angela Lau, Richard Long, Anu Parhar, Alena Tse-Chang, Shannon Turvey

Program Description

The Edmonton TB program comprises three components: outpatient clinics at the Aberhart Center; an inpatient isolation ward on 5C3 Walter Mackenzie Health Sciences Center, University Hospital; and a consultation service. More than ninety patients per year with active TB are managed by the program, and over three hundred patients per year are started on treatment for latent TB infection. The average census on the TB inpatient service is three. The TB physicians rotate for a week at a time for the inpatient service; one trainee at a time is accepted onto the service, and that individual participates in all three components of the program.