# Frailty in the Emergency Department: Screening, Intervention, and Alignment with the CMS Hospital Measure Frailty is a powerful predictor of adverse outcomes for older adults in the emergency department (ED), yet it often goes unrecognized in fast-paced clinical environments. During the February 23, 2026, Geriatric Emergency Department Collaborative (GEDC) webinar, expert panelists shared practical strategies for identifying frailty, integrating screening into workflow, aligning with the CMS Hospital Measure, and implementing evidence-informed interventions that improve patient outcomes. This resource synthesizes key insights from the panel and curates validated screening tools, implementation examples, quality improvement initiatives, and emerging research. Whether your ED is beginning to assess frailty or advancing system-level integration, this page offers actionable guidance to support age-friendly, high-quality emergency care. Outcomes Our understanding of frailty has evolved from a descriptive risk concept to a measurable, actionable driver of outcomes across patient, staff, and system levels. This section examines the growing body of evidence linking frailty identification and targeted intervention to meaningful outcomes, including reduced falls and delirium, safer decision-making, decreased readmissions, and more efficient resource utilization. It also explores how emergency clinicians operationalize frailty in real-world practice and highlights national efforts to define and standardize patient-centered outcomes for older adults. COMET Initiative| Ongoing research Development of a Core Outcome Set for research studies with older adults in the Emergency Department-CREAT-ED Visit Website COMET Initiative | June 20, 2017 The COMET Handbook: Version 1.0 View Article COMET Initiative | February 16, 2026 Development of a Core Outcome Set for research studies with older adults in the Emergency Department-CREAT-ED View Article Geriatric Nursing | 2024 Frailty means falling between the cracks: A qualitative study exploring emergency nurses' understanding of frailty and its use in informing clinical decision-making related to acuity, care, and disposition View Article Journal of Emergency Nursing | July 2019 Emergency Nurses' Perception of Geriatric Readiness in the ED Setting: A Mixed-Methods Study View Article Tools Validated, practical instruments and assessment strategies that support identification of frailty and functional decline in the ED. This section highlights performance-based mobility tests, updated frailty assessment frameworks, and emerging digital measures of physical and cognitive function. These tools are designed for rapid ED use and can inform risk stratification, fall prevention planning, and disposition decisions. CDC | STEADI Timed Up and Go Open PDF Short Physical Performance Battery Open PDF Five-Times-Sit-to-Stand Test Open PDF JACEP Open | February 2024 Frailty assessment tools in the ED: scoping review View Article Initiatives Programs, accreditation models, and collaborative efforts that operationalize frailty-informed emergency care. This includes system-level interventions such as automated referrals for high fall-risk patients, ED-based fall prevention trials, telerehabilitation pathways, geriatric readiness efforts, core outcome set development (CREAT-ED), and alignment with national frameworks like GEDA Accreditation Program. These initiatives demonstrate how frailty screening can move from concept to sustainable practice. JMIR Publications| November 18, 2025 Automated referral of high fall risk patients View Article Frontiers Public Health | December 17, 2025 Telerehab for falls in the ED  View Article MedRxiv| October 25, 2024 Using digital measures to assess physical function (and cognition) View Article Dartmouth Health Neighbors Helping Neighbors course View Program Annals of Emergency Medicine| August 25, 2020 Fall prevention RCT for patients presenting with falls to the ED View Article GEDA Accreditation Visit Website