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Objectives : The study was designed to review medication administration practices and organization in residential facilities for elderly dependent persons (EHPAD) in the Ile-de-France region and to identify areas for improvement.Method : This review was conducted in 2014 by means of a questionnaire concerning all the steps of the medication circuit sent to all EHPAD in the Ile-de-France region.Results : The response rate was higher than 70%, ensuring that the results are representative of all institutions in the region. Analyses showed a low use of prescription software despite the fact that 87% of EHPAD are equipped with such software, the non-systematic traceability of medication administration and a lack of tools to ensure a secure medication administration system : list of medicines suitable for the elderly (available in 36% of EHPADs), an adverse reaction management procedure (available in 39% of EHPADs). Analyses showed a diversity and heterogeneity of the medication administration system depending on the presence or absence of an in-house pharmacy and according to the type of institution (public or private). Several areas for improvement were identified to establish a good quality and safe medication administration policy in the institution, to improve drug prescription efficiency and to ensure safe medication administration.Conclusion : The institutions expressed great interest in medication administration systems and tools designed to monitor all stages of medication administration. A dozen simple and pragmatic improvement actions were identified and listed in the Ile-de-France Regional Health Agency action plan to improve medication administration management of in EHPAD.