Geriatric Emergency Management Network (GEM)

Provincial Initiative

Who is GEM for?

GEM is focused on specialized frailty focused nursing services in Emergency Departments. The Geriatric Emergency Management nursing network represents a service providing specialized frailty focused nursing services in many of the province’s emergency departments. It comprises 123 nurses in 56 emergency departments across Ontario lending their expertise to achieve better health outcomes to frail seniors or those at risk of frailty.

Why do we need GEM?

Seniors represent as many as 30% of the patients seen in Emergency Departments, more than any other age group. Illness complexity, hospital admission rates, lengths of stay and risk of functional decline are also highest for seniors. Indeed, emergency department visits are often sentinel events for seniors, threatening loss of independence, health and wellbeing. By providing specialized frailty friendly services in Emergency Departments, decline and loss of independence can often be prevented or postponed and repeat ED visits can be minimized.

How do GEM nurses differ from other ED nurses?

Emergency departments are developing specialized services to meet unique population needs such trauma, mental health, sexual assault and domestic violence. The needs of frail seniors are similarly unique and the presence of a specialized GEM nurse can help EDs manage frail seniors more effectively. GEM nurses bring with them knowledge of aging, understanding of the common geriatric syndromes and atypical presentation patterns, as well as intervention and prevention strategies that will help seniors maintain their level of independence and wellbeing. As a specialized role, GEM nurses focus on clinical consultation with patients and ED staff, education of patients/families and ED staff and in capacity building initiatives within their community and through provincial liaison.

How are referrals made to GEM nurses?

We encourage the use of a routine standardized risk screen for all seniors who come to emergency. Scores on the risk screen completed during primary assessment will indicate the need for a referral to the GEM nurse. Paramedic and ED staff can also ask GEM nurses to see seniors when they have an intuition or “gut feeling” that the GEM nurse could help even if the seniors risk screen score is not high. Seniors and their family members might also ask for the GEM nurse to become involved.

Who can I call to find out more about the GEM initiative in Ontario?

Please contact:

Ms. Kerri Fisher
Regional Geriatric Program of Toronto