Transitions of older adults between emergency departments and community care in Quebec: a case study
Bibliographic record
Abstract
• Establishing trust and continuity with older adults in the ED is challenging. • Strengthening primary care is crucial to better meet the needs of older adults. • Training efforts and mentorship are needed to support new nurse care coordinators. This study aimed to examine the care coordination processes and challenges between emergency department and primary care interdisciplinary teams, with a focus on the role of nurses in ensuring safe transitions for older adults. A case study was conducted within an Integrated Health and Social Services Centre in Quebec. Two types of data were used: documents and semi-structured interviews with 15 professionals involved in the transition. The Transitional Care Model guided the study. Several challenges were identified, namely establishing trust and continuity with older adults, balancing their wish to return home with ensuring their safety, the limited training of nurses to fulfill this role, the lack of communication across care levels, and the shortage of resources within primary care level. Given the aging population and its complex needs, it is urgent to move away from hospital-centrism and to strengthen primary care to enable older adults to age healthily in their community.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.010 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".