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GEM ROI Report

Quality Improvement & Evaluation

The older adult demographic experiences the greatest illness complexity, hospital admission rates, lengths of stay (LOS), and risk of functional decline. To address this, the Geriatric Emergency Management (GEM) program has been implemented in nine hospital locations within the Central East Region of Ontario. Through the GEM program, older adults receive specialized geriatric emergency management services in the hospital emergency department (ED). These services are provided by GEM nurses or nurse practitioners with advanced training in gerontology. 


This report presents findings from a return on investment (ROI) evaluation for the GEM program. The evaluation follows the ROI Methodology developed by Dr. Jack J. Phillips, which examines the program at several data levels: Program Inputs (level 0), Reaction (level 1), Confidence (level 2), Application (level 3), Impact (level 4), and ROI (level 5).

The older adult demographic experiences the greatest illness complexity, hospital admission rates, lengths of stay (LOS), and risk of functional decline. To address this, the Geriatric Emergency Management (GEM) program has been implemented in nine hospital locations within the Central East Region of Ontario. Through the GEM program, older adults receive specialized geriatric emergency management services in the hospital emergency department (ED). These services are provided by GEM nurses or nurse practitioners with advanced training in gerontology. 


This report presents findings from a return on investment (ROI) evaluation for the GEM program. The evaluation follows the ROI Methodology developed by Dr. Jack J. Phillips, which examines the program at several data levels: Program Inputs (level 0), Reaction (level 1), Confidence (level 2), Application (level 3), Impact (level 4), and ROI (level 5).

The older adult demographic experiences the greatest illness complexity, hospital admission rates, lengths of stay (LOS), and risk of functional decline. To address this, the Geriatric Emergency Management (GEM) program has been implemented in nine hospital locations within the Central East Region of Ontario. Through the GEM program, older adults receive specialized geriatric emergency management services in the hospital emergency department (ED). These services are provided by GEM nurses or nurse practitioners with advanced training in gerontology. 


This report presents findings from a return on investment (ROI) evaluation for the GEM program. The evaluation follows the ROI Methodology developed by Dr. Jack J. Phillips, which examines the program at several data levels: Program Inputs (level 0), Reaction (level 1), Confidence (level 2), Application (level 3), Impact (level 4), and ROI (level 5).

Related Resources

Related Resources

Central East Provider Experience Evaluation

Central East GAIN Evaluation 2018/2019

PGLO Older Adult Experience Survey

Intra-COVID Hybrid Adult Day Program Model Evaluation Report March 2020

PGLO Older Adult Experience Survey – Implementation Guide

Developmental Evaluation of the Community Geriatrics Nursing Specialist Model 2021/2022

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