Introduction: The PRISMA-7 tool [1] has been introduced in two emergency rooms (ERs) in Sherbrooke to identify older people with significant disabilities. The
seven yes/no questions had been included in the triage instrument for people aged 75 years and over. The positive cases were
directed to the single entry point of the local health and social services centre, which then conducted assessment and eventually
provided home care. The study's objective was to monitor the rate of PRISMA-7 use in ERs since its implementation (4 years
ago).
Results: During the first year of implementation, the rate of PRISMA-7 use gradually increased up to 50–60%, then remained stable during
the second and third years. This plateau can be accounted for, in part, by the scarcity of resources for assessing and delivering
home-care services. The rate of PRISMA-7 use fell to 40% during the fourth year, which coincided with renovation of an ER.
A 50% objective is in place.
Discussion: The rate of case-finding appears logical with the services actually available for assessing functional autonomy and the corresponding
home services required. In terms of the population-health approach for supporting functional autonomy, it highlights the challenges
in reaching the population level. As suggested by Young and Turnock [2], some managers consider publishing community-care waiting lists to increase attention and, consequently, priority in the
health system.
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1.
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PRISMA-7: a case-finding tool to identify older adults with moderate to severe disabilities. Archives of Gerontology and Geriatrics 2008; 47(1):9-18.
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2.
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Community care waiting lists and older people. British Medical Journal 2001 3; 322(7281):254.
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