Abstract
Introduction
People with frailty (Rockwood Frailty Score of 4 or more) represents 43% of the medical take at Withybush Hospital. There was a lack of front door frailty and comprehensive geriatric assessments (CGA). It was postulated that this was leading to delays in discharge and limiting the number of patients receiving a CGA by teams led by a geriatrician
Methods
In mid-November 2022, the acute medical take was adapted to stream stable patients with frailty through a frailty assessment unit. Prior to this, the area was being used as a surge ward for short stay acute medical patients. On the frailty unit, patients receive a CGA creating a problem list and plan. The patients are then streamed into either short stay and discharged from the unit itself or to an appropriate ward area. Number of discharges was the main outcome measure.
Results
In the 2 months preceding the intervention the number of discharges from the short stay assessment unit was 16% of total medical discharges. The percentage of patient’s discharged from frailty wards was also 16% of medical discharges. In the 2 months after the intervention, discharges from the frailty unit accounted for 21% of medical discharges. Discharges from the frailty wards accounted for 16% of medical discharges. In the post intervention months, the frailty team discharges accounted for 37% of total medical discharges.
Conclusions
Adoption of frailty unit model improved rates of short stay discharges and allowed frailty team to assess a greater proportion of the hospital patients. Using assessment by the frailty teams as a surrogate for a CGA this has significantly improved the proportion of patients receiving CGA to more fit our patient demographics.