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.
Available On-Demand
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What Matters in the ED: Addressing goals of care and meeting CMS Age-Friendly Hospital Measure in the Geriatric Emergency Department
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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:
What Matters Most in the Geriatric ED
September 19, 2022
Dr. Don Melady and a panel of experts discuss what matters most in the geriatric ED and how this can be integrated into the care of older adults.
Condensed Conversation Guide for Identifying Patient Priorities (The One Thing) Emergency Department version
Printable PDF from Patient Priorities
A free, printable conversation guide for use by ED clinicians developed by Patient Priorities Care Initiative in collaboration with Age-Friendly Health System initiative of the Institute for Healthcare Improvement.
Northwell Health GEDA Case Study – Goals of Care, Throughout, Clinical Outcomes
Read how New York’s largest healthcare provider is improving patient care and reducing length of stay and readmissions.
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.
10 Practical Tips for a Best Possible Medication History
Updated: March 30, 2021
Wenya Miao, BScPhm, PharmD, ACPR and Chris Fan-Lun (BScPhm, ACPR, BCGP
Pharmacists from Mount Sinai Hospital in Toronto share how to obtain a best possible medication history (BPMH) in the ED and provide an example script to follow.
A Pharmacist’s Role in the Senior-friendly ED
November 13, 2019
Don Melady
An interview with two senior-friendly pharmacists highlighting the important role of medication reconciliation for older ED patients and the benefits of involving a pharmacist in the ED team.
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.
Frailty in the Geriatric ED
November 17, 2022
An expert panel discusses frailty in the geriatric ED and why it is an important concept in the care of older ED patients.
Dementia in the Geriatric Emergency Department
January 16, 2020
Morgan Daven, Dr. Adam Perry, Dr. Chris Carpenter, Dr. Linda Schnitker, Dr. Michelle Moccia and Pamela Martin discuss quality care for older adults with dementia in the ED.
Dementia Implementation Toolkit
May 20, 2020
A dementia quality improvement implementation toolkit highlighting rationale, tools, protocols, and more.
Delirium Management Implementation Toolkit
May 18, 2020
An adaptable resource for implementing the best standards of care of older adults in the Emergency Department.
ED-DEL Change Package and Toolkit
May 10, 2021
This Change Package and Toolkit is designed to provide a structured approach, change strategies, resources, and a step-by-step guide to help you set up a Delirium Program in your ED.
Falls and Mobility Implementation Toolkit
May 20, 2020
This toolkit offers resources that are designed to allow you to create sustainable quality improvement in the care of older adults who have fallen or are at risk of falling.
How to Identify and Intervene for Geriatric Self-Neglect
July 20, 2022
Dr. Christina Shenvi is joined by Dr. Lauren Southerland for a conversation about self-neglect; a complicated geriatric syndrome that is both a diagnostic and care coordination challenge.
How to Help Prevent the Next Fall in Your Older Patients
May 31, 2022
Dr. Shenvi sits down with Dr. Elizabeth Goldberg to discuss ways to prevent and manage falls for older adults in the ED.
Safely Caring for the Agitated Older Adult in the Emergency Department
March 7, 2022
Dr. Shenvi sits down with Dr. Maura Kennedy to discuss safe and effective management of agitated older patients, and the role of dementia in producing these symptoms.
Dementia Care in the ED
December 12, 2021
Dementia in the ED is a critical and often overlooked issue. Dr Binkley and Dr. Shenvi discuss.
Failure to Thrive and Frailty
September 17, 2021
Dr. Shevnvi and Dr. Selman discuss the value and importance of understanding and evaluating frailty in older adults in the ED.
Clinical Frailty Scale App
The app is designed for frontline colleagues to download for use on mobile devices, to undertake clinical frailty scoring with patients in real time.
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.
Elder Mistreatment Resources for Interdisciplinary Clinicians
July 31, 2024
Get useful implementation and education resources to help you and your fellow clinicians identify and address elder mistreatment.
Elder Mistreatment Emergency Department Toolkit
February 21, 2022
The National Collaboratory to Address Elder Mistreatment
Easy-to-use resources to help Emergency Department staff identify and address mistreatment in older adults. Developed by the National Collaboratory to Address Elder Mistreatment.
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.
Nurse-Led Geriatric Case Management – the GEM Nurse Role
December 13, 2016
Don Melady, MD
A general FAQ about Geriatric Emergency Case Management (GEM).
GED Nurse Champion Education Resources
April 21, 2023
Aaron Malsch, MSN, RN, GCNS-BC
Aaron Malsch shares many great resources for training staff in the principles and clinical topics in geriatric care in the emergency department.
Geriatric Emergency Management Nurses in the Geriatric ED
January 30, 2023
This expert panel webinar explores the role of GEM nurses and provides guidance about how to implement a GEM nurse in your geriatric ED.
Models of Nurse Led Geriatric Case Management
October 19, 2020
Our interdisciplinary expert panel discusses the role of the GEM nurse and how this role can create significant improvements in ED care of older adults in both system-wide implementations or in a small rural ED.
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.