CMS Age Friendly Hospital Measure
Resources for Emergency Departments
On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Age-Friendly Hospital Measure that will take effect January 1, 2025. The measure, developed in collaboration with the American College of Surgeons (ACS) , the Institute for Healthcare Improvement (IHI) , and the American College of Emergency Physicians (ACEP) , aims to improve older adult patient care and outcomes.
The Age Friendly Hospital Measure targets five domains to prioritize older adults’ healthcare needs:
- Eliciting patient healthcare goals
- Responsible medication management
- Frailty screening and intervention
- Social vulnerability
- Age-friendly care leadership
The emergency department (ED) plays an important role in ensuring your hospital meets the Age-Friendly Hospital measure. Below we highlight key resources relevant to each domain from our resource library and our collaborators.
Through GEDC membership, we offer consulting services to help hospitals and healthcare systems align with the Age-Friendly Hospital Measure. Our team of experts assists your organization in integrating the 4Ms framework—What Matters, Medication, Mentation, and Mobility—into your clinical care practices.
And join us on November 18th at 3:00PM EST for an expert panel discussion in collaboration with ACEP on the new CMS Hospital Measure and how GEDA Accrediation and GEDC resources can help your hospital reach your goals.
Domain 1: Eliciting Patient Healthcare Goals
Determining the patients’ priorities is essential to providing the right care. In the ED this means having context-driven, direct conversations with your patient and learning what matters. The resources below give insight into this domain, and how to elicit goals of care explore the resources below:
Domain 2: Responsible Medication Management
Medication issues in older patients in the ED are among the most challenging and important areas of their management. In this era of chronic disease management, most older people come to the ED already taking five or more medications. Screening for high-risk medications is an essential part of good care of older adults coming to your ED. Some resources are below, and a new Toolkit for Medication Management is on the way.
E-Learning for Domain 2
Medication Management in the Older ED Patient
This module reviews the physiologic changes that occur with aging and the effect they have on how the aging body both processes and responds to medications. It reviews points about polypharmacy, communication, and strategies to manage especially high-risk medication classes.
Domain 3: Frailty Screening and Intervention
Older adults arriving in the emergency department are typically complex, with atypical presentations of disease related to normal changes in aging. Early detection of issues such as cognitive impairment, risks related to mobility, and frailty is advantageous to the emergency department care team’s plan for care, and results in improved patient experience.
This website is filled with resources on these topics. Below are a few high-value educational resources, but we encourage you to browse further.
E-Learning for Domain 3
The following e-learning courses are accredited for AMA and ANCC continuing education and cover key areas of geriatric emergency care.
Skills Fair: Mobility Risks and Falls
These five brief e-learning modules provide comprehensive training on mobility risks and falls. Begin with understanding the gravity of falls, work through a case study, then learn interventions for falls prevention, communication strategies, and how to make the case for value-based falls protocols.
Atypical Presentations in the Older ED Patient
This module uses a patient case to explore the anatomy, physiology, and pharmacology behind the patient's atypical presentation, and how to best manage such a patient.
Cognitive Impairment in the Older ED Patient
This module explores delirium, dementia, and depression in older adults in the ED, and best practices for screening, assessment, and management.
Emergency Management of Falls in the Older ED Patient
This module explores an approach to the management of the routine patient who has fallen, and what constitutes an adequate ED work-up of the first-time or frequent faller.
Frailty in the Older ED Patient
This module explores the concept and definitions of frailty and its clinical implication. It presents tools for screening for frailty and highlights discharge planning and frailty prevention in older ED patients.
Functional Assessment and Transitions of Care for Older ED Patients
This module follows three patients to the Emergency Department – all straightforward on the face of things, but complex once you dig deeper. We suggest a framework, some tools, and strategies for assessing ALL the components of their presentations. And we suggest some best practices for the most complicated of transitions – ED to nursing home.
Major Trauma in the Older ED Patient
This module addresses resuscitation of the older trauma patient. It reviews normal changes of aging and their effect on standard trauma resuscitation, and makes suggestions for major trauma resuscitation best practices.
Domain 4: Social Vulnerability
This domain ensures that the ED is aware of the social vulnerability of older adults and that the ED is sometimes the best positioned to intervene to identify and address social issues. The Educational Development Center has developed a series of educational modules alongside a quality improvement implementation toolkit that can be applied in any emergency department to meet this domain.
The EDC also supports emergency departments to adapt their toolkit to suit their organization’s unique needs. When you download the toolkit, you will receive more details.
E-Learning for Domain 4
Elder Mistreatment Emergency Department Toolkit Training Program
Four modules designed to train ED professionals in the use of the EMED Toolkit.
Critical Topics in Elder Mistreatment
These five brief e-learning modules explore the following topics as they relate to elder mistreatment: falls and medications; caregiver burden; decision-making capacity; delirium, dementia and depression; and lessons from forensic nursing.
Domain 5: Age-Friendly Care Leadership
This domain seeks to ensure consistent quality of care for older adults through the identification of a clinical champion to ensure compliance with all components of geriatric friendly care. In the case of many geriatric EDs this includes a GEM Nurse role and/or and Physician champion. To read more about GEM Nurses, see below.
Looking for more support and access to clinical experts as you work toward improved geriatric ED care? Become a GEDC Member today!
We offer comprehensive assessments and tailored strategies for process improvements, and we support your efforts to create a truly age-friendly environment. Whether you are looking to enhance patient-centered care, reduce potentially inappropriate medications, or improve mobility and cognitive health outcomes, our consulting services are designed to guide you every step of the way. With GEDC’s expertise, your institution can achieve compliance with CMS guidelines while fostering better health outcomes and patient satisfaction among your geriatric patient population.
Membership