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New emergency room initiative for geriatric Veterans at VA North Texas

Geriatric Vets


VA North Texas’ Dallas Medical Center Emergency Department treats over 22,000 Veterans over the age of 65 each year. Two-thirds of these Veterans leave with a new prescription.

To better improve care for geriatric Veterans, VA North Texas launched a new initiative known as EQUiPPED, or the Enhancing Quality of Provider Practices for Older Adults in the Emergency Department.

“EQUiPPED is a quality improvement program focused on medication safety for older adults discharged from the Emergency Department,” said Dr. Stephen Burgher, chief of emergency medicine service at VA North Texas.

New dashboard helps physicians

Physicians treating Veterans in the emergency department often prescribe their patients with a new medication before discharge. The new dashboard in EQUiPPED allows physicians to quickly access information on medications potentially harmful to older patients, allowing for the safest options. Certain medications prescribed to a healthy middle-aged adult might not have the same effect as if prescribed to a geriatric. The result would avoid potentially inappropriate medications.

EQUiPPED has a large informatics piece to it, an order menu and recommended medications with appropriate doses for geriatric patients.

“What EQUiPPED represents is the quality improvement of this mission,” said Dr. Rohit Manaktala, VA North Texas’ Section Chief of Quality Training and Education for the Emergency Department. “This new program will educate our providers who are used to providing in a much more age diverse group and alter their practice patterns and more importantly their prescribing patterns to cater to the geriatric population.”

VA North Texas is one of eight VA sites approved for EQUiPPED, and one of 12 VA-wide since 2012.

“We are all really excited to get EQUiPPED fully implemented here,” said Jaimie Ostrom, VA North Texas ED Clinical Nurse. “I think it’s really going to change and revolutionize geriatric emergency medicine nursing care.”


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