Presentations and Resources: Models and Examples of Primary Care Integrated Geriatric Teams (May 8, 2025)

This page includes all presentations from our webinar and additional resources suggested by our presenters. Access a Short Report on themes from session presentations and audience feedback here.

Presentations (by region in which the program is located)

East Region Goldhar

North East Gallagher and Paquette

Toronto Region Smith and Wolfe

West Region Heckman and Mensink

Central Region Gardhouse and Young

Additional References Suggested by Presenters

Beard, J.R., Officer, A., de Carvalho, I.A., Sadana, R., Pot, A.M., Michel, J.P., Lloyd-Sherlock, P., Epping-Jordan, J.E., Peeters, GMEEG., Mahanani, W.R., Thiyagarajan, J.A., Chatterji, S. (2016).  The World report on ageing and health: a policy framework for healthy ageing. Lancet 21 (387)(10033), 2145-2154. doi: 10.1016/S0140-6736(15)00516-4. Link to Article

Brooks, L., Elliott, J., Stolee, P. et al. (2023). Development, successes, and potential pitfalls of multidisciplinary chronic disease management clinics in a family health team: a qualitative study. BMC Primary Care 24 (126), 1-9. https://doi.org/10.1186/s12875-023-02073-x Link to Article

Chinda, B., Sepehri, K., Zou, M., Braley, M., Garm, A., Park, G., Rockwood, K., Song, X. (2019). The electronic frailty index based on the comprehensive geriatric assessment: Development and testing.  Innovation in Aging 3, Issue Supplement_1, S685–S686, https://doi.org/10.1093/geroni/igz038.2529

Heckman, G.A., Gimbel, S., Mensink, C., Kroetsch, B., Jones, A., Nasim, A., Northwood, M., Elliott, J., & Morrison, A. (2025). The integrated care team: A primary care based-approach to support older adults with complex health needs. Healthcare Management Forum 38 (3), 192-199. doi: 10.1177/08404704241293051.  Link to Article

Heckman, G., Gimbel, S., Morrison, A., et al. (2023). Preliminary Evaluation of a Shared-Care, Primary Care-Based Interprofessional Program to Support Older Persons Living with Frailty in the Community. In Abstracts from the 42nd Annual Scientific Meeting of the Canadian Geriatric Society. Canadian Geriatrics Journal 26 (2), 291. doi https://cgjonline.ca/index.php/cgj/article/view/686 Link to Article

Association of Family Health Teams of Ontario (AFTHO). (2020) InterRAI Check Up Tool Information Sheet. Link to Resource

Northwood, M., Saari, M., Heckman, G. et al. Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study. BMC Health Services Research 24, 864 (2024). https://doi.org/10.1186/s12913-024-11320-5 Link to Article

Miller, W.L., Cohen-Katz, J. (2010).  Creating collaborative learning environments for transforming primary care practices now. Families, Systems & Health, 28(4), 334-47. doi: 10.1037/a0022001. PMID: 21299280. Link to Article

Song, X., Park, G., Clarke, B., Rockwood, K. (2022). Early detection and management of frailty in primary care: Validation of the EFI-CGA with electronic health records. Innovation in Aging, 6, Issue Supplement_1,  25–26, https://doi.org/10.1093/geroni/igac059.094