Minimizing the Effects of Transferring Long Term Care Patients to the Emergency Department

Examining Aged Care Transitions (EXACT)



Unnecessary transitions of frail elderly nursing home residents to the hospital emergency department are costly and can negatively impact the resident’s quality of care and quality of life. Often times, the decision to transfer a resident is complex and unclear. This study identified attributes of avoidable transitions and factors influencing decisions-to-transfer in ambiguous cases.


Lead: Greta Cummings: University of Alberta, Faculty of Nursing in collaboration with the Brain Care Centre, the University of British Columbia, emergency medical personnel and continuing care managers, nurses, healthcare aides, physicians, and family council members from eight nursing home sites across Alberta.


Interviews and focus groups with key informants from eight nursing homes and survey data from 26 nursing homes in the Edmonton region were used to develop a draft decision-making guide to help front line staff determine whether or not to transfer a resident to the emergency department. An animated video was also developed that illustrates the harmful effects avoidable transfers can have on seniors.


The draft decision-making guide will be piloted for another year in several Edmonton sites for further development and adaptation in specific long term care contexts. The video, available below and on the Network website, promotes understanding and discussion about the importance of early detection and management of condition changes in residents to avoid unnecessary transfers.

Learn more: