Making the Emergency Department Safer for Seniors

GEM-ED (Geriatric Evaluation and Management – Emergency Department)



Emergency department use by seniors is rising, and a large number of seniors arrive with common geriatric problems such as cognitive and/or functional decline or falls, issues that can lead to poor outcomes. If, while treating immediate concerns, the emergency department could thoroughly assess patients most at risk for poor outcomes and connect them to appropriate community resources, these seniors may be better supported in the community and have less need for institutional or emergency care. The Geriatric Evaluation Management (GEM) service at the Misericordia Hospital Emergency Department is piloting this approach.


Lead: Dr. Jed Shimizu, Department of Geriatrics, Misericordia Community Hospital in collaboration with community resources and supports such as home care, geriatric outpatient clinics and outreach teams, and community seniors’ services and day programs.


The Misericordia Hospital Emergency Department implemented a focused geriatric assessment that examined medical concerns as well as cognitive and psychosocial factors and functional ability, in the context of the patient’s living environment and level of support. Once the assessment was completed, the emergency department team referred the patient to the appropriate community supports, including geriatric outpatient clinics, geriatric consult teams such as those in Home Care and Supportive Living, and specialty geriatric services such as geriatric psychiatry or rehabilitation programs.


So far, this model of care has assessed more than 300 seniors and transitioned more than 100 from acute care to community care by establishing links to a variety of support services. This is leading to better health outcomes for seniors and a reduced reliance on emergency care. This success has inspired the Grey Nuns Community Hospital and the Royal Alexandra Hospital to adopt the GEM-ED model.