SREMI Clinician Scientist Profile

Dr. Catherine Varner


In Canada, emergency departments play a critical role in pregnancy care. In fact, nearly half of women will visit an emergency department (ED) during or shortly after pregnancy. SREMI Scientist and Deputy Director Dr. Catherine Varner is regarded as an international expert on the care of pregnant patients in the ED. In January 2023, Dr. Varner and the SREMI team were thrilled to launch a new care program at Mount Sinai Hospital to improve care for patients experiencing pregnancy loss, an unfortunately common concern in the ED.

Virtual Wraparound Care is a first-of-its-kind program that begins at the point of care in the ED and continues after discharge. A specialized, advanced practice nurse, supervised by Dr. Varner, supports patients through their loss, is available to address their concerns as the loss progresses, and ensures timely follow-up care.

In March 2023, SREMI warmly welcomed Victoria Aziz to the role of Virtual Wraparound Care nurse navigator. A familiar face, Victoria is an RN who has worked in the Schwartz/Reisman Emergency Centre for many years before she transitioned into this role. The program has been an incredible addition to the ED, and more importantly, to the care of this vulnerable and frequent patient population.

The research evaluation of the program has started in the form of patient surveys and interviews, and so far, the feedback is very positive. This program has been a win-win for all involved: the patients receive more attentive and comprehensive care, and the ED has established more efficient follow-up care pathways with our gynaecology colleagues.

With the infrastructure of the program established, Dr. Varner and the SREMI research team applied for and received an innovation fund grant from the Mount Sinai Hospital-University Health Network Academic Medical Organization to co-design web-based supports for patients experiencing early pregnancy loss symptoms in the ED. This co-design project launched in July 2023 is in collaboration with Vitala Global, a not-for-profit organization that creates and supports reproductive technology solutions for pregnant people worldwide.

Dr. Varner also continues to utilize health administrative data housed at the IC/ES to examine how pregnant patients utilize the ED, how these visits influence pregnancy and infant outcomes, and how to improve system-wide pregnancy care. In the last two years, her work has gained national media attention following the publication of these novel reproductive health studies. Her research abstract entitled, “Maternal emergency department use before pregnancy and infant emergency department use after birth” received the Top Pediatric Abstract Award at this year’s Canadian Association of Emergency Physicians Annual Scientific Meeting.

Dr. Varner established a new collaboration in the area of pregnancy care for people with disabilities with Dr. Hilary Brown, an Associate Professor at the University of Associate Professor in the Department of Health and Society at the University of Toronto – Scarborough. Using IC/ES data, the project team evaluated whether people with disabilities are at greater risk of ED use in pregnancy compared with those without disabilities. The findings of this study were also published in JAMA Network Open in August 2023. This successful collaboration has continued, and the project team was awarded a five-year Canadian Institutes of Health Research Project Scheme Grant to evaluate pregnancy outcomes and care of women with physical-mental multimorbidity.

In January 2023 Dr. Varner assumed the role of Deputy Editor of the Canadian Medical Association Journal. This summer she published two editorials on ED crowding, both resulting in national media attention. Her editorial entitled, “Emergency departments are in crisis now and for the foreseeable future” was one of the most read articles in the journal in 2023. The follow-up editorial entitled, “Without more acute care beds, hospitals are on their own to grapple with emergency department crises” was included in briefings of Deputy Health Ministers and Health Ministers at national meetings held in September and October, respectively.