Geriatric Emergency Management (GEM) is a provincial program aimed at promoting better health outcomes for frail seniors who visit the emergency department. GEM provides comprehensive geriatric assessment to high-risk seniors and makes recommendations for care and community supports. Another geriatric-focused program at the Markham Stouffville Hospital Corporation (MSHC) is the Nurse-Led Outreach Team to Long-Term Care (NLOT). GEM and NLOT share tools, resources and knowledge related to geriatrics best practices. Also supported by the Regional Geriatric Program of Toronto, and funded by Aging at Home, NLOT provides rapid assessment of residents otherwise destined for the emergency department (ED), as well as planned ambulatory access/rapid ED engagement strategies to seven local long term care facilities. Wait times and length-of-stay are reduced, especially for long term care residents who present to the ED. There has been a significant decrease in resident transfers to the emergency department. In the first quarter of 2010, of 106 LTC residents consulted by NLOT, only 22 were transferred to the ED, thus 88 residents (79%) received timely and appropriate care right in their home.

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