The regionalization of healthcare in Alberta has been instrumental in changing the way we deliver healthcare to the population. In Calgary, the restructuring involved the closing of three acute care hospitals and a significant reduction in beds per capita. This reduction in inpatient beds behooved Senior Management in acute care to be innovative and responsive to the utilization of existing resources. The Department of Patient Transition Services was conceived with a mandate to provide assistance and support in utilization management and discharge planning, administrative coordination, system support and integration support. The evolution of this unique department is described.