Dr. Audrey-Anne Brousseau outlines five practical, time-saving strategies to improve care for older adults in the emergency department.

Five Practical Tips to Improve Geriatric Care Efficiency in the Emergency Department

Dr. Audrey-Anne Brousseau, Canada

Improving geriatric care in the ED doesn’t require a complete overhaul — it starts with how we show up at the bedside. One of the most common things we hear is, “I’d love to do more, but I just don’t have the time.”

Here’s the good news: being efficient and thorough with older patients in the ED is possible — and that’s exactly what this approach is all about.

1. Start with the Medication List

Take a good look at the medication list — it’s a goldmine. It’ll give you a snapshot of their medical history and what has changed recently. It’s a quick, efficient way to orient yourself.

2. Check Their Recent ED Visits and Admissions

A quick review of their last 6–12 months can tell you a lot:

• More than 1 admission in the past year?
• More than 2 ED visits?

Those are red flags for functional or medical decline. Take note.

3. Get Collateral History Early

Before even seeing the patient (or while the caregiver is present), gather some key context:

• Where do they live?
• How are they functioning at home?
• Are there any safety concerns?
• What are their goals of care?

This gives you a head start and keeps you focused when you meet the patient.

4. Talk Less, Listen More

When you’re in front of the patient, start with an open-ended question — like we were taught in medical school. But here’s the part we weren’t taught well enough:
Pause. Listen. Stay quiet.
Let the silence happen. That 60 seconds of uninterrupted listening will often give you the best history you’ll get.

After that, ask about pain and screen for delirium.

5. Do the Walk Test

Yes, the full physical exam matters — but if you only have time for one thing, get them on their feet.

The walk test is a functional goldmine, telling you information about:

• Cognitive function
• Neuro and MSK assessment
• Cardio-respiratory effort
• Skin integrity
• Overall safety and discharge readiness

It’s your all-in-one assessment tool.

Bonus: Small Gestures, Big Impact

Before stepping away:

• Let the nurse know the patient can eat, drink, move around, and should have access to a comfortable chair and a walking aid if needed.

And if you have a minute, ask about their past occupation or something personal. It’s a powerful way to connect — and it reminds us that emergency medicine isn’t just about diagnoses, it’s about people.

Try it with your next patient.
It will take you about 15–20 minutes — and it’s a worthwhile investment. You’ll walk away with clarity, even before imaging or labs come back.

Good luck!
Let’s make geriatrics in the ED smarter, not harder.