Disclaimer: This blog is for informational and educational purposes only, intended for healthcare professionals and organizations. It does not constitute medical or professional advice. Full disclaimer here.
In Canada, emergency department (ED) transfers from long-term care (LTC) facilities are a growing concern. These transfers can be stressful for residents, contribute to ED overcrowding, and often result in hospitalizations that could have been avoided with sufficient on-site care.
A 2014 study estimated that over 60,000 LTC patient transfers to EDs occurred in Canada, with up to 25% deemed potentially preventable (PubMed). Addressing this issue requires a multifaceted approach, including better reporting systems, expanded on-site care, and stronger interdisciplinary collaboration.
The Need for Standardized Reporting on Preventable Transfers
Currently, Canada lacks a nationwide system that provides LTC facilities with reports on transferred residents and whether these transfers could have been prevented. Without this feedback, facilities miss opportunities to improve care and reduce unnecessary hospital visits.
The Canadian Institute for Health Information (CIHI) reported that in 2013–2014, one in three ED visits from LTC residents were potentially preventable (CIHI Report). Common reasons for these preventable visits include:
✅ Falls ✅ Urinary tract infections (UTIs) ✅ Pneumonia ✅ Medication issues ✅ Behavioral disturbances
Proven Strategies for Reducing Preventable Transfers
Several initiatives have demonstrated success in reducing unnecessary ED visits from LTC homes:
1. Interdisciplinary Care Teams
A scoping review found that implementing interdisciplinary care teams within LTC facilities reduced ED transfer rates by 10% to 70% (Cambridge Journal). These teams include:
- Geriatric specialists
- Nurse practitioners
- Pharmacists
- Social workers
2. Community Paramedicine Programs
Nova Scotia’s Extended Care Paramedic (ECP) program deployed paramedics to LTC homes, allowing residents to receive urgent care on-site instead of being transported to an ED. Over a 41-week period, 73% of patients were treated without needing hospital transport (EHS Nova Scotia).
3. Enhanced On-Site Services
Providing advanced nursing care, point-of-care diagnostics, and telemedicine consultations in LTC homes has been shown to significantly reduce avoidable transfers. For example, integrating telemedicine for after-hours physician assessments led to a 60% reduction in hospital transfers (JAMDA Study).
Call to Action: Strengthening LTC Systems
To reduce preventable ED transfers, we must:
✅ Establish a national reporting system to track and analyze preventable ED visits. ✅ Expand community paramedicine programs to provide urgent care in LTC settings. ✅ Invest in interdisciplinary teams that proactively manage residents’ health. ✅ Enhance on-site medical capabilities with telemedicine and advanced nursing care.
Reducing preventable ED transfers is not just about alleviating hospital overcrowding—it’s about providing dignified, high-quality care for our aging population.
How can we collaborate to implement these solutions more effectively? Drop your thoughts in the comments! 👇
