Assessment of the documentation of frailty at admission in emergency general surgery admission at a tertiary care hospital

Background

NHS frailty guidelines advise that frailty score should be documented at the first time of contact for patients aged 65+ years. The Aim of this quality improvement project (QIP) was to assess the adequate documentation of frailty at the time of first encounter by the general surgery department for patients aged 65+ years.

Method

Data was collected for October 2022 for the first cycle and January and February 2023 for the second cycle. Data collection was done from an electronic database in the trust and patient notes maintained throughout the admission.

Results

136 patients were included in the QIP for the first cycle. 3/136 (2.2%) patients had documented frailty at the first encounter. These findings were discussed in the clinical governance meeting, followed by a teaching session for the junior doctors. A specific section was added in the documentation as a reminder for the team to document the frailty upon the first encounter.

212 patients were included in the second cycle and documentation of frailty improved to 39/212 (18.4%).

Conclusion

There was a lack of documentation, which improved after the intervention advised by QIP. A teaching session for new junior doctors is planned at the induction session, to strengthen the importance of frailty documentation.