What is GEM?

GEM stands for Geriatric Emergency Management. This program is designed to enhance the care of frail, community-dwelling seniors in the ED.

The goal of the GEM Clinical Specialist Program is to deliver emergency comprehensive geriatric assessment (eCGA) and interventions to older adults and their care partners in the Emergency Department, in order to:

• Connect them with community services and resources that better meet their health needs; and
• Enhance/maintain their level of independence and quality of life.
• Prevent further functional decline and avoid unnecessary hospital admissions and the need for repeat visits.

Why is the GEM Program is Necessary

Demographics: Older adults (75+) make up around 30% of ED visits, the highest among any age group.

Risks: Seniors are at increased risk for longer stays, repeat visits, and hospital admissions.

Challenges: Without early interventions, ED visits can often lead to a loss of independence and worsening health outcomes.

Solution: GEM Clinical Specialists mitigate these risks through targeted interventions and linking with Community Resources.

Key Responsibilities of GEM Clinical Specialists

1. Comprehensive Geriatric Assessment

• Focused assessment on older adults with complex medical, functional, and/or psychosocial needs.
• Addresses geriatric syndromes such as falls, delirium, dementia, depression, elder abuse, and functional decline.

2. Care Planning and Coordination

• Creation of individualized care plans based on patient assessment.
• Coordination with community services, outpatient specialist geriatric services, and primary healthcare providers.

3. Education and Mentorship

• Educating ED staff and healthcare teams on geriatric care.
• Building capacity within the ED by implementing senior-friendly care processes and policies.

4. Collaboration

• Strengthening relationships between the ED and local geriatric resources.
• Ensuring a seamless transition from the ED to home or other care facilities.

GEM Clinical Specialist Referral Process

Referrals: GEM Clinical Specialists are consulted for older adults identified through a standardized risk screen during primary assessment.

Staff-Initiated Referrals: Referrals to GEM Clinical Specialists will be triggered when the TRST tool is completed and a positive screen results. This simple tool is to be completed for anyone presenting to the ED over the age of 75. The tool is to be completed at Triage. Physicians/NP’s can also order a GEM referral, as well, the primary nurse can contact GEM directly (ext. 2304).

Family Requests: Families can also request GEM services if they feel their loved one could benefit from the program.

Impact of the GEM Clinical Specialist Role

Improved Patient Outcomes:

• By addressing geriatric-specific needs, GEM Clinical Specialists help prevent functional decline and maintain independence.

Reduced ED Visits and Hospital Admissions:

• GEM interventions reduce repeat ED visits and hospitalizations, improving patient flow and reducing healthcare costs.

Enhanced Patient Experience:

• Timely and comprehensive care improves the overall experience for both patients and their families.

If you have any further questions or would like more details about the GEM Clinical Specialist program, please don’t hesitate to reach out, and I would be happy to assist. Ext.2304.