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Technology and health care for the elderly medical research studies

Focus on strategic priorities that have significant social impact.

FRA 2015-A-06

Post-emergency department evidence-based interventions for the prevention of frailty and functional decline in injured community-dwellers

At the end of this project, we will be able to summarize all evidence-based post-ED community services that help restore functional ability and prevent frailty from the international literature and generate a toolbox of recommended post-emergency department (ED) community services that could be implemented in the Canadian context in undetected pre-frail/frail community-dwellers.

Research Results

Findings: There is limited high-quality evidence on optimal and effective transition services following ED discharge, but there is a trend in favour of holistic geriatric assessment and targeted referral to community services tailored to individual needs of injured seniors (e.g., multifactorial fall-prevention programs). Interventions to restore or maintain functional status of injured older patients following ED visit should be further investigated and improved coordination of services along the continuum of care for community-dwelling seniors, with emphasis on primary and secondary preventive interventions requires additional attention.

Impact of findings: Our team called the Canadian Emergency Team Initiative (CETI) previously created and validated a simple Clinical Decision Rule tool (CETI-CDR) that empowers ED professionals to screen, and direct post-ED care of frail. However, broad adoption of the tool has proven difficult. The completed scoping review is intended to describe evidence about successful interventions for the discharged elderly at risk of functional decline which will support implementation of CETI-CDR. This knowledge synthesis study will help ED physicians and allied health care professionals optimize care of community-dwelling seniors in order to aid the recovery of patient’s autonomy following injury by presenting a broad range of potential post-ED interventions.

Publications, presentations and webinars

For more information on why this research matters, click the links below:

Policy        Families        Researchers

About the Project

In a recent nation-wide meeting with clinicians, stakeholders and researchers; our group identified a gap in knowledge for evidence-based post-acute care interventions for semi-independent and independent elders. Comprehensive knowledge is needed about how to orient this population once the frailest injured independent elders are identified.

Our main objective is to complete a knowledge synthesis in order to help clinicians, patients, decision makers, stakeholders and researchers to know where to orient those patients. Specifically, we will 1) identify community services aiming to help restore the patient’s previous state of independence; 2) create a tool-box of potential post-ED/community services to help pre-frail independent elders with minor injuries; 3) identify which services are most efficient in recovery of the patient’s independence.

We will do a scoping review that will include a stakeholder/key informant focus group. The purpose of a scoping study is to review the literature without evaluating or interpreting the findings. It is a pragmatic approach that is useful in grasping the broader issues. The proposed study involves five steps: (1) identification of the research question, (2) identification of relevant studies, (3) selection of studies, (4) charting the data and (5) collating, summarizing and reporting results. English and French documentation from Canada, USA, France, England and Australia will be included.

For more details on the project rationale, hypothesis, objectives and research plan, click here.

Project Team

Principal Investigators:

Marcel Émond, MD, MSc -- Université Laval

Marie-Josée Sirois, OT, PhD -- Université Laval/CHU de Québec

Co-Investigators:

Katherine Berg, PhD, PT -- University of Toronto

Debra Eagles, MD, FRCPC -- The Ottawa Hospital

Jacques Lee, MD, FRCPC, MSc -- Sunnybrook Health Centre

Jeffrey Perry, MD, MSc, CCFP-EM -- Ottawa Hospital Research Institute

Nancy Salbach, BSc, BScPT, MSc, PhD -- University of Toronto

Laura Wilding, RN, BScN, MHS -- The Ottawa Hospital

Knowledge Users and Partners:

Centre d'excellence du vieillissement de Québec (CEVQ)

Project Contact: Marcel Émond -- marcelemond1@me.com

FRA 2015-A-06