C McInnes, N Moultrie, A Wells, F Campbell, E Macdonald, E Tan


  • Geriatrics and Gerontology
  • Aging
  • General Medicine

Abstract Introduction Older people with frailty are at risk of adverse outcomes from hospital admission. Early identification of frailty at can help reduce these. The Clinical Frailty Scale (CFS) identifies frailty, is quick to perform and can be done in acute settings. We have a well-established a Frailty Assessment Unit (FAU) which supports comprehensive geriatric assessment (CGA) for older adults with frailty in hospital. We developed direct admission pathway for frail patients direct from our emergency department (ED) to FAU and we needed to ensure that CFS was performed in the ED. Methods A training and education programme in CFS was delivered to ED via Frailty nurse practitioners. CFS was embedded in the ED safety briefs and daily handovers. A Frailty link nurse was identified in ED. We implemented an electronic CFS Frailty Alert (eFA) to our electronic Patient Management System. Results A direct admission pathway was established in March 2021 and eFA began in September 2021 (delayed due to Covid-19). The number of patients presenting to ED who have eFA added at admission has increased from 4/month to 100/month. This has allowed us to maintain 80% of patients being admitted to FAU (and therefore to GCA) < 24 hours of attendance at hospital. The number of patients who have an eFA recorded in the overall service has also increased. Conclusion We improved the number of patients with an eFA in ED and can better identify who needs CGA. We can use eFA as a visual tool for site awareness of frailty which helps to support flow. Capability of ED /hospital teams to add eFA was increased and extended to Hospital@Home/ community teams. Finally, this has been shared across our NHSL sites.

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