# Enhancing Medication Management in the Geriatric ED What's Inside? This toolkit provides tools, guidelines, and educational resources for emergency department (ED) administrators and teams to successfully implement medication management quality improvement projects and support safe prescribing - and de-prescribing - in the ED for complex older patients. EDs looking to provide excellent care for older adults should review medications to identify potentially inappropriate medications (PIMs) for older adults. This toolkit provides background and examples of successful methods for doing so. Importantly, it also includes a slide deck for making the case for a medication management quality improvement project which provides the evidence for the financial and patient impacts of these initiatives. The resources below are intended to help staff and administrators provide evidence for the justification for implementing a medication management quality improvement program supported by a pharmacist consult as part of the interdisciplinary team. Making the Case for Pharmacist Involvement in the Emergency Department Slide Deck This slide deck is available for download and editing. You can adapt this to create a presentation for your hospital, C-suite, or stakeholders. It provided evidence for the financial impact of implementing medication management quality improvement protocols, hiring pharmacists or pharmacy techs as a resource for the geriatric ED, and more. Continue The Geriatric Emergency Department model relies on the establishment of an interdisciplinary team to manage the multimorbidity and complexity of care of frail older adults. Many care process for older adults could include a pharmacy consult, especially since these patients may require a new or different prescription. Below are job descriptions for both a pharmacist and pharmacy technician that could be adapted by ED administrators to suit their needs.  Geriatric Emergency Department Pharmacist Example Job Description Downloadable .docx that can be adapted for your emergency department. Continue Geriatric Emergency Department Pharmacy Technician Example Job Description Downloadable .docx that can be adapted for your emergency department. Continue BLOG | November 13, 2019 A Pharmacist's Role in the Age-Friendly ED In the ED, pharmacists play a crucial role in optimizing medication management and safety in older adults. Explore Resource Each care process that your ED develops should include education for relevant (if not all) ED staff, physicians, and stakeholders about the process. Below are self-directed, asynchronous, online courses and materials for listening that may be helpful. ONLINE LEARNING | Geri-EM Medication Management in the Older ED Patient AMA and ANCC Credits This one-hour module will review the physiologic changes that occur with aging and demonstrate the effect they can have on how the aging body both processes and responds to medications. Case studies illustrate points about polypharmacy, communication, and strategies to manage especially high-risk medication classes. Explore Course PODCAST | October 25, 2024 Why Less is More: Strategies for Deprescribing in the ED In this episode, Dr. Christina Shenvi and Dr. Martin Casey will discuss strategies for ED physicians who face unique challenges when assessing older patients’ medications. Using case examples of deprescribing in practice, they illustrate how deprescribing is a nuanced skill and how to approach it. Listen Now As ED sites build and enhance partnerships to support the geriatric ED model, there are several opportunities to leverage pharmacy support for practices that advance responsible medication management. These will also help hospitals meet the CMS Age-Friendly Hospital Measure, or help toward GEDA Accreditation.  BLOG | June 16, 2025 Medication Reconciliation and Comprehensive Medication Review Avoiding adverse drug events requires a multi-step process. Learn the basics of how it's done. Explore Resource BLOG | June 13, 2025 Minimizing PIMs in the Geriatric ED Get high-level guidance around creating a care process for triggering medication reconciliation and minimizing potentially inappropriate medications (PIMs) in the ED. Explore Resource BLOG | July 11, 2025 Clinical Decision Support for Safe Prescribing in the Geriatric ED How hospitals can improve prescribing through simple modifications to the EMR - lessons from the EQUiPPED program with examples. Explore Resource BLOG | June 20, 2025 Meeting Domain 2 of the CMS Age-Friendly Hospital Measure Meet the attestation requirements by conducting medications reviews and identifying PIMs at multiple steps in the care pathway. Explore Resource BLOG | March 30, 2021 10 Practical Tips for a Best Possible Medication History Quick and easy review of tips from two emergency department pharmacists familiar with geriatric care. Explore Resource BLOG | January 13, 2017 Best Possible Medication History (BPMH) Interview Guide Obtaining an accurate medication history before admission or at discharge is an essential part of geriatric emergency care. This script can help teams get a complete history. Explore Resource Older adults arriving at the emergency department are likely to receive a new prescription before being discharged. Below are some tools for identifying potentially inappropriate medications for older ED patients. Annals of Emergency Medicine | September 2024 Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients Go American Geriatrics Society| 2023 AGS Beers Criteria List The Beers Criteria provides a list of all medications that may be inappropriate for older adults. Go Order sets for common geriatric presentations should all include particular attention to geriatric appropriate medications, and dosing and management plans. The order sets below have incorporated appropriate medication notes for consideration in your older ED patients. They are available with word document downloads for adaptation in your own department's EMR or charts. Delirium Management and Prevention Example Order Set Appropriate use of non-pharmacological and pharmacological interventions for older ED patients. Continue Contributors