Emergency Room Visits and Older Patients (ER2)

Study Overview
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Brief Summary
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Today's population is living longer than prior generations. Senior patients, defined as 65 years or older, are therefore increasing in number, and representing a larger number of hospitalized patients. Thus, assessing and addressing the needs of the growing number of older ER users is essential. The overall objective of the study is to examine the feasibility and the epidemiology of two screening tools (Programme de Recherche sur l'Intégration des Services pour le Maintien de l'Autonomie (PRISMA-7) and Emergency Room Evaluation and recommendations (ER2)) used in the Emergency Room of Jewish General Hospital to screen older patients (i.e.; ≥65 years) at risk of adverse health events. A prospective observational cohort design will be used for the study's two phases; phase 1- assessment and phase 2- assessment as well as recommendations.

Official Title
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Emergency Room Visits and Older Patients: Assessment of Jewish General Hospital Program Screening Frail Users

Conditions
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Emergencies, Length of Stay

Intervention / Treatment
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* Other: ER assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 65 years. Unplanned ER visits. Exclusion Criteria: Death within the 24 hours of first visiting ER. Palliative care due to ER visit.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: ER assessment|To measure the effects of recommendations of ER2, the investigators will use ER users who will have an ER2 assessment without any recommendations as the referent group the older. This choice is possible because ER2 will be integrated into ER care in two steps: The first step will be limited to its assessment component in order to learn how to use the tool. The second step will be to follow the recommendations provided after the assessment. Participants will follow-up during their hospitalization via a review of their chart. They will be censored when they will be discharged from the JGH or when the duration of hospitalization will exceed 31 days.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of using both tools in the ER | Percentage of participants with complete filed tools (older patients with tools filed / (older patients visiting the ER) x 100) will be calculated. | 1 day | 
| Prevalence of tools filed | Prevalence will be calculated for PRISMA-7, ER2 and pooled tools respectively. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of tools | Estimation of quality of filling using the percentage of items filled in for participants with an incomplete tool. | 1 day | 
| Length of stay | The LHS will be calculated using the administrative registry of the JGH and will correspond to the delay in days between the first day of admission to ED and the last day of hospitalization in the acute ward(s). | 1 day | 
| Acute medical events | Acute medical events occurring during the period of the ER visit and admission to the medical or surgery ward (acute organ failure, nosocomial infection, fall or death) | 1 day |