OPTIC Research Program



We investigated care transitions experienced by residents of nursing homes. The specific aim is to better understand transitions from long-term care (LTC) facilities to Emergency Department (ED) via emergency medical services (EMS) or inter-hospital transfer (IHT).

We also sought to determine costs of transfers from system and family/resident perspectives; to develop a practical tool to assess transfer success, in terms of quality of care and avoidable complications; and to analyze the influence of organizational factors in key practice locations (nursing homes, pre-hospital transport services, and emergency departments) on transfer success. The initial OPTIC 4-phase study occurred over a 36-month period (starting Nov 2009) as a partnership between Alberta and British Columbia involving the University of Alberta, University of British Columbia Okanagan, Alberta Health Services, and Interior Health Authority.

All transfers of residents over one year from the nursing home, via the emergency medical system to the emergency department were studied, as well as further in-depth analyses of nursing homes with the highest referral rates. The residents, their families, transport crews, physicians and staff were interviewed to create a picture of the resident's care in each of the three settings and to describe a successful transition.

The results of this study included the development of tools (T3, OPTICS) used to measure successful transitions of nursing home residents to the emergency department and back to the nursing home. This will help improve quality of care and reduce the burden on busy emergency departments. This knowledge will help managers make better informed decisions and will improve the lives of the frail elderly who experience these transitions.

Key Findings & Publications

  • Tate K, McLane P, Reid RC, Rowe BH, Estabrooks C, Norton P, Cummings GG. (2022). Assessing quality of older persons’ emergency transitions between long-term and acute care settings: A proof of concept study. BMJ Open Quality. 11(1):e001639. doi: 10.1136/bmjoq-2021-001639
  • Tate K, Reid RC, McLane P, Cummings GE, Rowe BH, Estabrooks CA, Norton P, Lee JS, Wagg A, Robinson C, Cummings GG. (2020). Who doesn't come home? Factors influencing mortality among long-term care residents transitioning to and from emergency departments in two Canadian cities. Journal of Applied Gerontology. Open Access https://doi.org/10.1177/0733464820962638
  • Cummings GG, McLane P, Reid RC, Tate K, Cummings GE, et al. (2020). Fractured care: A window into emergency transitions in care for long term care residents with complex health needs. Journal of Aging and Health, 32(3-4): 119-133 doi: 10.1177/0898264318808908
  • Reid RC, Cummings GE, Cooper SL, Abel S, Bissell LJ, Estabrooks CA, Rowe BH, Wagg A, Norton PG, Ertel M, Cummings GG. (2013). The Older Persons' Transitions in Care (OPTIC) study: Pilot testing of the transition tracking tool.  BMC Health Services Research, 13 (515). doi: 10.1186/1472-6963-13-515
  • Robinson CA, Bottorff JL, Lilly MB, Reid C, Abel S, Lo M, Cummings GG. (2012). Stakeholder perspectives on transitions of nursing home residents to hospital emergency departments and back in two Canadian provinces. Journal of Aging Studies, 26 (4): 419-427. doi:10.1016/j.jaging.2012.06.001,  http://www.sciencedirect.com/science/article/pii/S0890406512000497


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