When long-term care residents fell sick with respiratory infections five years ago during the COVID-19 pandemic, they often waited days for test results. By then, outbreaks had already spread through entire floors. A new study from Toronto suggests that simple, fast testing right inside nursing homes could have changed that story entirely.
Researchers from Sunnybrook Health Sciences Center, Michael Garron Hospital, Humber River Health and the University of Toronto partnered with 20 long-term care homes across Toronto to test whether giving homes their own rapid testing machines would help catch infections sooner. The answer, it turns out, is yes in a big way.
During the 2024 to 2025 respiratory virus season, half the participating homes used onsite rapid testing while the other half sent specimens to off-site laboratories the traditional way. Homes with rapid testing got results in under one hour instead of the usual three to five days. They also tested their residents more than twice as often, because waiting days for results makes doctors less likely to order tests unless someone is very sick.
The impact was clear. Residents at homes with onsite rapid testing had an 11 percent lower chance of being transferred to a hospital emergency department for complications from respiratory infections. Researchers calculated this worked out to about four avoided emergency department visits per 100 beds over the course of the respiratory season. The study was published in JAMA Internal Medicine and is called the PROMPT-LTC trial.
Jerome Leis, a medical director at Sunnybrook and one of the study's lead researchers, said the pandemic exposed how badly the old testing system failed vulnerable seniors. "Outcomes like hospitalization and death are directly linked to how quickly an outbreak is detected," Leis said, "but the good news is we can now do better in LTC homes than we did in the past."
Staff at the participating homes received training from infection control teams at local hospitals. At Baycrest, one of the homes that took part, workers are now using those skills to train their colleagues too. Lisa Marcovici, director of resident care at Baycrest's Apotex Center, said the partnership made all the difference. "Our staff now have the confidence and skills to not only support testing but train and educate other staff, which allows us to build greater care capacity within the home."
If this approach were adopted across Canada, researchers estimate it could prevent 8,000 transfers to hospital emergency departments every year during the November to March respiratory season, when hospitals are already stretched thin. Leis argues that the upfront cost of equipping long-term care homes with rapid testing machines is worth it. "Bringing hospital-level testing into LTC homes is a major improvement in quality of care for residents," he said. "Knowing that this approach improves resident outcomes and can free up health care capacity should justify the upfront cost."