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Related Experiment Video

Updated: May 21, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Does a Targeted Engagement and Diversion program reduce emergency department utilization?

Rebecca Seliga1, Krishan Yadav2,3, Caroline Hodgins4

  • 1Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada. rseliga@toh.ca.

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|March 22, 2025
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Summary
This summary is machine-generated.

The Targeted Engagement and Diversion (TED) program successfully diverted 71.8% of unhoused patients from emergency departments. This program offers a viable solution for reducing emergency department overcrowding and improving healthcare access for vulnerable populations.

Keywords:
Emergency departmentIll-housedInner city health

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Area of Science:

  • Public Health
  • Health Services Research
  • Emergency Medicine

Background:

  • The Targeted Engagement and Diversion (TED) program in Ottawa offers healthcare services to unhoused or shelter-housed adults outside of emergency departments (EDs).
  • Emergency departments face significant overcrowding, necessitating alternative care models for vulnerable populations.
  • Understanding the effectiveness of diversion programs is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

  • To determine the proportion of patients successfully diverted from emergency departments by the TED program.
  • To evaluate the impact of the TED program on healthcare utilization patterns among unhoused individuals.
  • To assess the feasibility of the TED program as a strategy for ED offloading.

Main Methods:

  • A retrospective health records review of adult patients attending the TED program between January and December 2022.
  • Random sampling was employed to account for seasonal variations in patient visits.
  • Data were extracted from the Ottawa Inner City Health database and hospital records, with successful diversion defined by specific clinical and service utilization criteria.

Main Results:

  • A total of 500 visits from 241 unique patients were reviewed; 71.8% (95% CI 67.7-75.6) of visits met criteria for successful diversion from the ED.
  • The most frequent reason for presentation was unspecified intoxication (83.4%).
  • A significant majority of diverted patients (82.8%) revisited the TED program within 7 days, while only 7.9% visited an ED within the same period.

Conclusions:

  • The TED program demonstrates success in engaging patients and diverting them from busy EDs.
  • This model of care shows potential for alleviating pressure on overcrowded EDs.
  • The program may improve access to comprehensive care for unhoused individuals, with long-term outcomes including stable housing for 39% of patients over two years.