{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:40:57Z","timestamp":1792705257387,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Healthc Manage Forum"],"abstract":"<jats:p>Persistent wait times in Specialized Geriatric Services increase risks for older adults living with frailty and place additional pressure on primary care. While workforce shortages contribute to delays, variation across programs suggests that access is also influenced by how referral, triage, assessment, follow-up, and care integration are organized. The Regional Geriatric Program of Toronto conducted a multi-phase engagement initiative including a targeted literature scan, stakeholder interviews and surveys, and a regional summit to identify system-level barriers and prioritize opportunities for improvement. Findings converged on four interconnected domains: referral and triage, comprehensive geriatric assessment design, follow-up and discharge, and integration with primary and community care. Stakeholders prioritized clinically guided triage, tailored assessment pathways, clearer follow-up accountability, strengthened shared care models, and enhanced data infrastructure. These findings identify opportunities to strengthen access through coordinated system planning, operational improvements, and regional leadership within existing resource constraints.<\/jats:p>","DOI":"10.1177\/08404704261496452","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:38:32Z","timestamp":1792489112000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding and Addressing Wait Times in Specialized Geriatric Services: Findings From a Multi-Phase Engagement Process"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1197-2486","authenticated-orcid":false,"given":"Hinna","family":"Hasan","sequence":"first","affiliation":[{"name":"Regional Geriatric Program of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gabor","sequence":"additional","affiliation":[{"name":"Regional Geriatric Program of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta M.","family":"Hillier","sequence":"additional","affiliation":[{"name":"St. Peter\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Chan","sequence":"additional","affiliation":[{"name":"Regional Geriatric Program of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Marr","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"St. Michael\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Liu","sequence":"additional","affiliation":[{"name":"Regional Geriatric Program of Toronto"},{"name":"University of Toronto"},{"name":"Sunnybrook Health Science Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"Provincial Geriatrics Leadership Ontario. More than 1.1 million Ontario older adults may be living with frailty by 2040. https:\/\/geriatricsontario.ca\/news\/more-than-1-1-million-older-adults-may-be-living-with-frailty-by-2040\/. Accessed August 11 2026."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-010-0020-2"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.5770\/cgj.23.448"},{"key":"e_1_3_6_5_2","volume-title":"Presented at: Canadian Geriatrics Society Annual Scientific Meeting","author":"Popp P","year":"2022","unstructured":"Popp P, Hillier L, Siemon J, Marr S. Describing wait times associated with access to geriatric medicine consultation in the outpatient setting in Ontario, Canada. In: Presented at: Canadian Geriatrics Society Annual Scientific Meeting. 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Wellesley Institute; 2021. https:\/\/www.wellesleyinstitute.com\/the-cost-of-waiting-for-ltc-qualitative-study\/"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/fmch-2024-002729"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12131339"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/13561820.2017.1303463"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12459"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa191"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18031"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.14283\/jfa.2023.23"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics4040059"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.1476"},{"key":"e_1_3_6_17_2","volume-title":"Implementation Framework for Integrated Care for Older People (ICOPE)","author":"World Health Organization","year":"2019","unstructured":"World Health Organization. Implementation Framework for Integrated Care for Older People (ICOPE); 2019. https:\/\/www.who.int\/publications\/i\/item\/9789241515993. Accessed August 11, 2026."},{"key":"e_1_3_6_18_2","volume-title":"Shared Health Priorities Indicators","author":"Canadian Institute for Health Information","year":"2024","unstructured":"Canadian Institute for Health Information. Shared Health Priorities Indicators. CIHI; 2024. https:\/\/www.cihi.ca\/en\/bulletin\/shared-health-priorities-indicators-june-2024. Accessed August 11, 2026."},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz021"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.7022"},{"key":"e_1_3_6_21_2","unstructured":"Ontario Health. Operational Direction: Priorities for Spring\/Summer 2026. May 4 2026. 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