What is EQUiPPED?
EQUiPPED is a quality improvement program that focuses on medication safety in older adults discharged from the Emergency Department (ED). It includes clinical and educational tools for use by clinicians in every day practice as well as tools for quality managers and institutions to track performance.
EQUIPPED was developed by an interdisciplinary team comprised of ED physicians, geriatricians, gerontologists, clinical pharmacists and quality improvement nurses in the VA.
Why does EQUiPPED Matter?
ED use by older adults has risen dramatically over the past decade. As of 2013, adults ages 65 and older account for >19 million ED visits in the US. Between one-half and two-thirds of older patients are discharged from the ED after a diagnosis and treatment plan have been formulated. Adding to the complexity of caring for the elderly in the ED, between 40-66% of these older patients are prescribed at least one new medication upon discharge from the ED. Problems with the quality of discharge medications such as potentially inappropriate prescribing have been described in a number of studies in the ED. There is accumulating evidence that inappropriate medication use is associated with increased risk of hospitalization among older adults. Avoiding the use of inappropriate and high-risk drugs is an important, simple, and effective strategy to reduce medication-related problems in older adults.
What is the Aim of EQUiPPED?
EQUiPPED is a quality improvement initiative aimed at changing prescribing practices of ED providers in order to decrease the use of potentially inappropriate medications (PIMs), as described by the Beers List, in patients age 65 and older who are discharged from the ED Ultimately, we will evaluate if improved prescribing practices reduce ED representation and subsequent hospitalization.
What are the EQUiPPED interventions?
EQUiPPED includes three primary areas of intervention:
- Provider education – including tools for group didactic session, ED journal clubs and individual provider academic detailing
- Informatics based clinical decision support – with templates for electronic medical record (EMR) embedded geriatric pharmacy order sets and links to online geriatric content
- Individual provider performance feedback including audit and feedback, and peer benchmarking
What are the EQUiPPED locations?