Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups.

About

Older adults are among the most prevalent users of Emergency Departments. For some older adults, their visits to the Emergency Department are not always because of an emergency medical situation. This project identifies the unmet care needs of community-dwelling older adults (aged 65+) and the social, structural, and systemic inequities that have contributed to their potentially avoidable visits to the Emergency Department. Given the heavy burden on many emergency departments in hospitals across Canada, it is important to address the issues that lead to avoidable visits so that resources can be directed appropriately, and to make sure that the needs of health service users are adequately met. We hope that this study can identify the key factors that lead to avoidable Emergency Department visits for seniors and inform how to better address their care needs.

This project began in December 2022 at the Saint John Regional Hospital and St. Joseph’s Critical Care Unit in Saint John, New Brunswick. The project has since been replicated at the Montfort Hospital in Ottawa, Ontario. We are currently in Phase 3 of the project where we are conducting co-design workshops with patients, caregivers, and ED and primary care clinicians.

Funding

AFP Acceleration Grant Montfort Hospital

New Brunswick Health Research Foundation

Medical Student Summer Research Program, University of Ottawa

Research Team

Project Lead: Krystal Kehoe MacLeod kmacleod@bruyere.org

Research Coordinator: Eunice Hammond ehammond@ohri.ca

2024-25 Research Assistant (ON): Paul Ioudovski paul.ioudovski@uottawa.ca

2024-25 Research Volunteer (ON): Nazanin Soghrati nsoghrati@qmed.ca

2025 Research Volunteer (ON): Laura Jamieson 23206268@studentmail.ul.ie

2024 Research Assistant (ON): Khachadour Bandk kband100@uottawa.ca

2023-24 Research Assistant (NB): Karyle Nama Flores karyle.flores@horizonnb.ca

2023-24 Research Assistant (ON): Katelyn Wang katelyn.wang@uottawa.ca

presentations

Bandk K, Wang K, Flores K, Hammond E, Kehoe MacLeod K. Identifying therapeutic benefits of qualitative research interviews for community-dwelling older adults with high emergency department use from historically marginalized groups in Ontario and New Brunswick. (November 28, 2024). Bruyère Health Annual Research Day. Ottawa, Ontario, Canada. Poster presentation.

Wang K, Flores K, Hammond E, Johnston S, Chandra K, Kehoe MacLeod K. (November 28, 2024). Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups in Ontario and New Brunswick. Bruyère Health Annual Research Day. Ottawa, Ontario, Canada. Oral presentation and poster presentation.

Hammond E, Ioudovski P,Bandk K, Wang K, Maloney B, Gravel J, Johnston S, Kehoe MacLeod K. (November 28, 2024). Co-designing hospital- and community- based interventions with older adults to improve care delivery at the Montfort Hospital emergency department and in the surrounding community in Ottawa, Ontario. Bruyere Health Annual Research Day. Ottawa, Ontario. Poster presentation and poster presentation.

Hammond E, Bandk K, Ioudovski P, Wang K, Flores K, Maloney B, Ireland L, McDougall P, Gravel J, Johnston S, Kehoe MacLeod K. (October 24-27, 2024). Identifying barriers to care for older adults from linguistic and ethno-cultural minority groups leading to potentially avoidable emergency department visits. Canadian Association of Gerontology 53rd Annual Scientific and Educational Meeting. Edmonton, Alberta. Poster presentation.

Ioudovski P,Hammond E, Bandk K, Wang K, Maloney B, Gravel J, Johnston S, Kehoe MacLeod K. (October 24-27, 2024). Co-designing hospital- and community- based interventions with older adults to improve care delivery at the Montfort Hospital emergency department and in the surrounding community in Ottawa, Ontario. Canadian Association of Gerontology 53rd Annual Scientific and Educational Meeting. Edmonton, Alberta. Oral presentation.

Ioudovski P,Hammond E, Bandk K, Wang K, Maloney B, Gravel J, Johnston S, Kehoe MacLeod K. (October 24, 2024). Co-designing hospital- and community- based interventions with older adults to improve care delivery at the Montfort Hospital emergency department and in the surrounding community in Ottawa, Ontario. Medical Student Summer Research Day 2024, University of Ottawa, Ontario. Oral presentation.

    McDougall P, Flores K, Wang K, Hammond E, Johnston S, Maloney B, Ireland L, Chandra K, Kehoe MacLeod K. June 9-12, 2024. Exploring the drivers of potentially avoidable emergency room visits by community-dwelling older adults from historically marginalized groups in New Brunswick and Ontario. Canadian Association of Emergency Physicians (CAEP) Annual Research Meeting. Saskatoon, Saskatchewan. Poster presentation.

    Wang K, Flores K, Hammond E, Johnston S, Chandra K, Kehoe MacLeod K. May 13-17, 2024. Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups in Ontario and New Brunswick. Le 91e Congrès de l’Association francophone pour le savoir. Ottawa, Ontario. Oral presentation.

    Wang K, Flores K, Hammond E, Gibb M, Johnston S, Chandra K, Kehoe MacLeod K. May 14-16, 2024. Exploring the drivers of potentially avoidable emergency room visits by community-dwelling older adults from historically marginalized groups in New Brunswick and Ontario. Canadian Association of Health Services and Policy Research (CAHSPR) 2024. Ottawa, Ontario. Poster presentation.

    Kehoe MacLeod K, Jamieson L, Wang K, Flores K, Hammond E, Johnston S, Maloney B, Ireland L, & Chandra, K. Apr 22-24, 2024. Identifying barriers to integrated and equitable care for older adults from minority groups leading to potentially avoidable emergency department visits. The International Conference on Integrated Care. Belfast, Northern Ireland. Oral presentation.

    Wang K, Flores K, Hammond E, Johnston S, Chandra K, Kehoe MacLeod K. (Nov 15-16, 2023). Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups in Ontario and New Brunswick. Ottawa Hospital Research Institute Research Day 2023. Ottawa, Ontario. Poster presentation.