SCOPE Nurse Navigators Rachel Humphries (left) and Sarah Furnival (right) play a key role in connecting primary care providers to hospital-based resources.
Dr. Nikki Reklitis remembers the case clearly. A patient who needed urgent care, but didn’t quite meet the threshold for an immediate trip to the Emergency Department (ED).
Instead of sending the patient to wait in a busy ED, Dr. Reklitis called SCOPE Niagara.
“Thanks to the SCOPE Nurse Navigators, who quickly connected me with the general internal medicine physician on-call and diagnostic imaging – the patient was able to be assessed quickly and proceed with next steps in her care journey,” she says.
The patient avoided the ED entirely – and still got the care she needed.
That’s thanks to the crucial role of SCOPE Niagara – Seamless Care Optimizing the Patient Experience - a program that connects primary care providers in the community to a team of nurse navigators and specialists at Niagara Health who offer real-time support for complex and urgent patients.
Now celebrating its third anniversary, SCOPE Niagara has grown from 30 original participants to more than 227 physicians and nurse practitioners across the Niagara region. The program has become a lifeline for family doctors like Dr. Reklitis, who are often the first point of contact for patients but don’t always have quick access to specialty care.
“As a family doctor you’re often asking yourself, ‘Is this an ED visit? Do I need imaging first?’ SCOPE Niagara helps you answer that question – quickly,” says Dr. Reklitis.
Developed under the Niagara Ontario Health Team – Équipe Santé Ontario Niagara, the program connects primary care providers with specialists in general internal medicine, diagnostic imaging, palliative care, nephrology and mental health. The team includes two nurse navigators, who guide each request based on urgency and need.
Sarah Furnival, one of the program’s original nurse navigators, says her role has evolved alongside the program. What started with four clinical pathways has since expanded, and the volume of requests has more than quadrupled.
“When we launched, we were getting about 40 calls a month. Now it’s around 160,” says Furnival. “That means we’re helping more patients avoid unnecessary trips to the ED — and getting them the care they need faster.”
BY THE NUMBERS:
(Since April, 2024)
- More than 40 local providers have joined the program
- More than 1,160 calls received by the SCOPE Niagara team
- 91 per cent of calls prevented Emergency Department visits
- More than 100 calls to our Mental Health and Addictions pathway
Since April 2024, the program has taken more than 1,160 calls with 91 per cent of those calls successfully preventing ED visits — a testament to the program’s effectiveness.
For Dr. Reklitis, it’s that kind of outcome that makes the program indispensable.
“In the first five years of practice, especially, having SCOPE Niagara is so valuable,” she says. “Being able to speak directly with a thrombosis specialist or someone in internal medicine makes a huge difference — for me and for my patients.”
Rachel Humphries, SCOPE Niagara’s Mental Health and Addictions Nurse Navigator, joined the team in early 2024 as part of the growing demand for mental health support. Her work helps connect primary care providers with psychiatrists and community resources — often in real time.
“When a provider calls with a patient in crisis, I can usually direct them to the right resource right away or even set up an urgent appointment,” she says. “We’ve had many situations where that one call made all the difference.”
The feedback from primary care providers has been overwhelmingly positive. Providers cite reduced stress, better access and more confidence in managing complex cases.
“When we first heard about SCOPE Niagara, it seemed too good to be true,” says Paul Schmidt, Office Assistant for Dr. Bob McMillan. “A team of nurse navigators dedicated to helping primary care providers navigate the hospital system and solve problems in a timely manner? Yes, please!”
Schmidt says the SCOPE team has exceeded expectations.
“When Dr. McMillan has a patient with a complex case, he is grateful to be able to relay detailed questions to radiologists and specialists through the SCOPE team,” says Schmidt. “The prompt answers we receive ensure that the appropriate investigations are ordered without delay, and our patient receives the best possible care.”
“This isn’t just a convenience,” says Dr. Reklitis. “It’s a patient-first model. If I can avoid sending someone to the ED and still get them help, that’s a win for everyone.”
