Emergency Departments (EDs) and Injury Units are seeing a steady rise in attendances from older adults, with more than 560 people aged 75 and over presenting every day. To ensure that every older person receives safe, timely and respectful care, regardless of when or where they attend, a new national Quality Improvement Programme (QIP) has been developed.
The QIP is structured around three priority areas designed to standardise and strengthen care nationwide:
• Minimum Care Standards for Older Adults in EDs and Injury Units
• Post-Triage Assessment and Bundles of Care
• Education and Workforce Development
Older adults face unique risks in the emergency care environment, including functional decline, delayed assessment and increased vulnerability to delirium, frailty and falls. Many of these risks are not detected at standard triage. The QIP addresses this by promoting consistent minimum standards and introducing structured post-triage assessment bundles to ensure early identification and tailored care.
Key recommendations include avoiding MTS Category 5 triage for patients aged ≥75 unless clearly justified, reviewing Category 4 cases where uncertainty exists and embedding a post-triage assessment bundle for all older adults. This bundle incorporates the 4AT Delirium Screen, Clinical Frailty Scale, Falls Risk Assessment, Trauma Safety Net Checklist and a “What Matters to You” prompt-supporting more person-centred, age-attuned decision-making.
Developed in partnership with the National Emergency Medicine Programme and informed by teams across University Hospital Limerick, Sligo University Hospital, Beaumont Hospital, Cork University Hospital and St Vincent’s University Hospital, the QIP reflects a national shift toward needs-based, value-driven emergency care for older people.
The QIP is under review by the Chief Clinical Officer Forum and is expected to be launched in Q1 2026.
