Grant: Embedded Clinician Researcher Salary Award - Central Canada

Each year in Canada, nearly 500 000 community-dwelling seniors sustain injuries that are not fatal but that limit their mobility and daily activities. The vast majority of these seniors seek medical care in Emergency Departments (EDs) and two-thirds are discharged back home with various minor injuries. Evidence generated by the Canadian Emergency Team Initiative (CETI), has shown that these minor injuries can trigger a downward spiral of functional decline (in mobility and daily activities) in 16% of seniors who are still independent at the time of their injury. Moreover, these injuries unmask early signs of impairments as well as a pre-frail/frail status. As there are no ED management guidelines designed to prevent these injured seniors from losing their mobility and function, they deteriorate within 6 months post-ED discharge. This is unfortunate as there is compelling evidence of the effectiveness of community-based mobility interventions in improving frailty & function. Such interventions include fall prevention & exercise programs, which are available across all Canadian communities. In that context, identification of seniors at risk of functional decline is crucial in EDs to implement effective interventions. The CETI has validated a Clinical Decision Rule (CETI-CDR) to screen & orient seniors at high, moderate & low risk of decline to appropriate post-ED follow-ups. We thus propose the new CEDeComS intervention that combines CETI-CDR screening with rapid linkage to mobility programs in the community, directly from the ED. The main objective of this study is to assess the effectiveness of the new CEDeComS intervention on reducing functional decline in seniors presenting to the ED with minor injuries. The study builds on the formation of new ED-community partnerships that will improve the care continnum to help these seniors remaining independent.