A Connolly, R Oates

1609 IMPROVING STREAMING OF FRAIL OLDER ADULTS FROM THE EMERGENCY DEPARTMENT TO A FRAILTY UNIT

  • Geriatrics and Gerontology
  • Aging
  • General Medicine
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Abstract Introduction It is well recognised that frailty is increasing amongst the population and can impact outcomes for patients when admitted to hospital. Frail older adults are more vulnerable to developing complications form continued hospital admissions. National recommendations by GIRFT indicate CFS scores ought to be documented in the Emergency Department (ED) to facilitate early recognition of frailty and stream patient to the appropriate pathway and clinician. The aim of this is to ensure the correct Clinician reviews the frailer adult in the most appropriate setting and thereby reduce risk of deterioration and patient harm. In October 2022 an electronic patient record system (EPR). Bolton NHS Trust has created a dedicated frailty unit staffed by Geriatricians for older frail adults. Therefore, a method of identifying and streaming frailer older adults is crucial to effectiveness of the unit. Methods PDSA cycles were implemented. A retrospective audit was performed prior to the implementation of the CFS documentation. A robust education programme was introduced to all clinical staff in the Emergency Department. Online modules were also available. A second audit as part of PDSA cycle was then performed to assess the intervention. Results Pre-intervention and EPR documentation tool only 11% of patients had CFS score. Following the intervention, 88% of medical staff included the CFS score in their assessment prior to a Frailty team referral and review. The frailty team have observed an increase in referrals. Conclusions Early recognition and documentation has enabled improved streaming and review of the correct patients to the frailty unit. This has enabled Gold Standard of Comprehensive Geriatric Assessment for frailer adults to be completed. Further PDSA cycles to the effectiveness of the unit are ongoing. Initial data indicates with correct identification and recognition of frailty; the average length of stay has reduced.

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