Strengthening our Long-Term Care, Together: PREVIEW-ED© Spread Collaborative


“This pan-Canadian collaborative will bring together teams to spread a proven innovation that will not only reduce emergency department transfers--but even more importantly--will improve resident care and experience where they live.”

Maria Judd, Vice-President, Programs, CFHI



Call for Applications

The call for applications is now closed. CFHI will communicate directly with all applicants. A merit review will take place and teams will be announced in the coming months.



Key Dates

  • March 5, 2018: Call for applications launched 
  • March 5 - April 15, 2018: Pre-application informational calls available upon request
  • March 22, 2018: Informational Webinar2
  • April 15, 2018: Deadline for submission of application (Expression of Commitment)
  • May 28 – June 1: : Communication informing teams of their selection
  • May 2018 – March 2019: Webinars and coaching
  • June 4, 2018: Deadline for signed Memorandum of Understanding (MOU)
  • June 19 – 20, 2018: Collaborative Launch Workshop 
  • July – September 2018: Pre-implementation period and training
  • September 2018 – March 2019: Implementation period
  • March 2019: Results Webinar (date to be confirmed)

Note: Dates are subject to change.

1“Network” refers to a group of long-term care facilities with regional oversight that will form a team for the pan-Canadian spread of PREVIEW-ED©

Note: Email us to request a recording of the informational webinar (


PREVIEW-ED© is an innovative screening tool, developed by Marilyn El Bestawi through CFHI’s Executive Training program: EXTRA. The tool helps staff in long-term care (LTC) detect early health decline among residents related to four conditions: pneumonia, urinary tract infections (UTI), dehydration and congestive heart failure (CHF). It measures the signs, symptoms and severity of nine indicators using a simple scale that allows the users to score each indicator and generate an aggregate score to quantify the change. The one-page tool takes between 8-15 seconds to administer per resident by Personal Support Workers or Care Aides as part of their regular duties.

The tool was piloted in a sample of long-term care homes in Toronto in 2012 and in Fraser Health in 2016-2017, and contributed to a significant reduction of ED transfer rates.

Learn more about PREVIEW-ED© »

Fraser and Interior Health PREVIEW-ED© Spread Collaborative

The proportion of Canadians 65 and older is growing faster than any other age group. By 2031 Canadian seniors will account for 22.8% of the population. Seniors living in long term care have a high risk of being admitted to hospital. A 2014 CIHI report showed that about one in three emergency department (ED) visits among seniors living in long term care (LTC) is potentially avoidable. 1 Studies of the elderly admitted to hospital report 22.9% to 43.9% experience one or more iatrogenic illnesses* with potential for serious or fatal complications.2 The most common reasons for these avoidable visits are urinary tract infections, pneumonia and falls. These conditions could be managed at the facility, by direct care staff, to avoid an ED visit altogether. 3

The Canadian Foundation for Healthcare Improvement (CFHI) has developed a partnership with Fraser Health and Interior Health focused on spreading the Practical Routine, Elder Variants Indicate Early Warning for ED (PREVIEW-ED©) tool to residential homes in the Fraser Health and Interior Health regions of British Columbia.

Forty residential care homes across Fraser Health and three homes in Interior Health are participating in the first phase of the PREVIEW-ED© Spread Collaborative, where the tool is being rolled-out and used daily.  The second phase roll-out of PREVIEW-ED© will take place in 2017/18 across remaining residential care homes in both regions.

Learn more about the Fraser and Interior Health PREVIEW-ED© Spread Collaborative »

*when a patient acquires an illness or injury from services provided by a medical provider.

1Canadian Institute for Health Informatics (CIHI). (November 2014). Sources of Potentially Avoidable Emergency Department Visits. Retrieved from
2 Jensen PM, Fraser F, Shankardass K, Epstein R, Khera J. Are long-term care residents referred appropriately to hospital emergency departments? Can Fam Physician 2009 May;55(5):500-505.
Walker JD, Teare GF, Hogan DB, Lewis S, Maxwell CJ. Identifying potentially avoidable hospital admissions from Canadian long-term care facilities. Med Care 2009;47(2):250-254.