Sequential implementation of the EQUIPPED geriatric medication safety program as a learning health system

Ann E. Vandenberg, Michelle Kegler, Nicole Hastings, Ula Hwang, Daniel Wu, Melissa B. Stevens, Carolyn Clevenger, Stephanie Eucker, Nick Genes, Wennie Huang, Edidiong Ikpe-Ekpo, Denise Nassisi, Laura Previll, Sandra Rodriguez, Martine Sanon, David Schlientz, Debbie Vigliotti, Camille P. Vaughan

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To present the three-site EQUIPPED academic health system research collaborative, which engaged in sequential implementation of the EQUIPPED medication safety program, as a learning health system; to understand how the organizations worked together to build resources for program scale-up. Design: Following the Replicating Effective Programs framework, we analyzed content from implementation teams’ focus groups, local and cross-site meeting minutes and sites’ organizational profiles to develop an implementation package. Setting: Three academic emergency departments that each implemented EQUIPPED over three successive years. Participants: Implementation team members at each site participating in focus groups (n = 18), local meetings during implementation years, and cross-site meetings during all years of the projects. Intervention(s): EQUIPPED provides Emergency Department providers with clinical decision support (education, order sets, and feedback) to reduce prescribing of potentially inappropriate medications to adults aged 65 years and older who received a prescription at time of discharge. Main Outcome Measure(s): Implementation process components assembled through successive implementation. Results: Each site had clinical and environmental characteristics to be addressed in implementing the EQUIPPED program. We identified 10 process elements and describe lessons for each. Lessons guided the compilation of the EQUIPPED intervention package or toolkit, including the EQUIPPED logic model. Conclusions: Our academic health system research collaborative addressing medication safety through sequential implementation is a learning health system that can serve as a model for other quality improvement projects with multiple sites. The network produced an implementation package that can be vetted, piloted, evaluated, and finalized for large-scale dissemination in community-based settings.

Original languageEnglish
Pages (from-to)470-476
Number of pages7
JournalInternational Journal for Quality in Health Care
Issue number7
StatePublished - 1 Aug 2020


  • Emergency medicine
  • Geriatrics
  • Health services research
  • Patient safety
  • Potentially inappropriate medication list


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