The Impact of a Geriatric Multidisciplinary Team in the Emergency Department

The Integration of a Geriatric Multidisciplinary Team (Geri MDT) in the Emergency Department

The care of geriatric patients frequently involves members of the multidisciplinary care team, including both primary medical staff and allied health professionals. Often, members of the multidisciplinary care team are mobilized after geriatric patients have presented to the emergency department and have been seen by a doctor. Mobilizing these resources sequentially in inefficient and can lead to delays in geriatric patients receiving holistic care early following their presentation to the emergency department. The goal of this observational study is to assess the impact of having a geriatric-focused multidisciplinary team (Geri-MDT) dedicated to the emergency department that can be mobilized easily and in parallel at the time of presentation. The main questions we hope to answer in this study are:

• Does the Geri-MDT increase care efficiency by reducing the amount of time patients spend in the ED?
• Does the Geri-MDT decrease the proportion of patients that are ultimately admitted to the hospital?
• When patients are admitted, does the Geri-MDT reduce the length of stay in hospital?

Study Overview

• Status: Completed
• Conditions: Length of Stay; Emergency Geriatric Care; Geriatric Health; Admission to GIM

Detailed Description

Older adults represent a growing proportion of the population and frequently present to hospitals with complex medical, cognitive, functional, and psychosocial needs that require interdisciplinary management. They are also at heightened risk of functional decline when accessing health services, with delays in care coordination contributing to unnecessary hospitalizations and hospitalization-associated disability. Improving outcomes for this population requires proactive, collaborative mobilization of multidisciplinary teams at the time of presentation, rather than reactive or fragmented responses. To address this need, we established a Geriatric Multidisciplinary Team (Geri-MDT) dedicated to the emergency department (ED). The Geri-MDT includes a geriatric nurse, physiotherapist, occupational therapist, social worker, and geriatrician, who together provide early triage and coordinated care for older adults presenting to the ED. We hypothesized that early, well-coordinated involvement of this team would reduce ED length of stay, decrease unnecessary admissions, and shorten inpatient admissions when required.

• Study Type: Observational
• Enrollment (Actual): 1012

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montreal, Quebec, Canada, H3T 1M5
      • St. Mary's Hospital Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population is comprised of patients 65 years or older who present to the emergency department at St. Mary's hospital in Montreal and meet the inclusion criteria as described above.

Description

Inclusion criteria for the retrospective analysis were:

1. evaluation by at least one allied health professional, including a geriatric nurse, geriatrician, physiotherapist, occupational therapist, or social worker;
2. age 65 years or older; and
3. availability of the medical record in the hospital's electronic medical record (EMR) system.

Exclusion Criteria:

(1) data not available in the EMR.

In the post-implementation period, patients were flagged for Geri-MDT assessment if they met any of the following criteria:

1. age over 85 years,
2. a score of ≥4 on the Program of Research to Integrate the Services for the Maintenance of Autonomy 7 (PRISMA-7) frailty screening tool, or
3. an ED presentation related to a geriatric syndrome (e.g., fall, delirium, dementia, urinary incontinence, functional decline, or elder abuse).

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Pre-implementation; Standard of care before the implementation of the Geri-MDT
Post-implementation; After the implementation of the Geri-MDT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Admission rate	The proportion of geriatric patients that present to the emergency department that are admitted as inpatient to the hospital.	From enrolment to the end of the study period, up to 1 year.
Time in emergency department	The length of time, in hours, Geriatric patients spend in the emergency department.	From enrolment to the end of the study period, up to 1 year.
Length of hospitalization	The length of time, in days, that patients spend in the hospital if admitted.	From enrolment to the end of the study period, up to 1 year.
Return to emergency department	The rate of patients returning to the emergency department following discharge.	Quantified as either representing to the emergency department within 7- or 30-days following discharge.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mobilization of geriatric multidisciplinary team members	The number and proportion of geriatric patients presenting to the emergency department who are seen by one or more members of the multidisciplinary care team.	From enrolment to the end of the study period, up to 1 year.

Collaborators and Investigators

• Sponsor: St. Mary's Research Center, Canada

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Actual): July 1, 2024
• Study Completion (Actual): July 1, 2024

Study Registration Dates

• First Submitted: December 17, 2025
• First Submitted That Met QC Criteria: April 22, 2026
• First Posted (Actual): April 30, 2026

Study Record Updates

• Last Update Posted (Actual): April 30, 2026
• Last Update Submitted That Met QC Criteria: April 22, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: emergency department; early intervention; multidisciplinary team; hospital-associated disability
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Pathological Conditions, Signs and Symptoms; Emergencies
• Other Study ID Numbers: 2025-1139

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No