Abstract
Background
Frailty in over 65s is common, but is not often assessed on medical admission at Barnsley Hospital. Identifying frail patients is clinically important, as it can highlight those who may benefit from a Comprehensive Geriatric Assessment –an intervention which has been shown to reduce mortality and improve independence.
Introduction
At Barnsley Hospital, only 13.49% of patients aged over 65 admitted to the Acute Medical Unit (AMU) were found to have a documented Rockwood Clinical Frailty Score (CFS). This project aimed to increase this to a target of 30%.
Methods
A survey conducted amongst clerking doctors (27 respondents) identified multiple barriers to documenting frailty, which influenced a quality improvement project with 4 PDSA cycles.
Changes made included: modifications to the electronic clerking template, education around frailty, posters, and a daily frailty WhatsApp reminder.
The effectiveness of each PDSA cycle was assessed by a retrospective audit of the percentage of over 65s admitted to AMU per day receiving a CFS assessment.
Results
A total of 2816 patient admissions were reviewed over a 3 month period. Rates of CFS documentation improved from a baseline of 13.49% to 21.42% after cycle 1, 28.43% after cycle 2, 28.13% after cycle 3, and 28.19% after cycle 4.
Conclusion
Although the intended target of 30% was not met, this project achieved a significant increase in the rate of CFS documentation for patients admitted to a busy AMU. Overall the programme was well received, although further work is needed to continue to improve frailty recognition.
Comments
Really interesting…
Really interesting presentation and poster. You mentioned that a frailty score can be useful for highlighting patients that would benefit from a geriatric review and CGA during admission. Are there any plans to develop a system to flag these patients up to specialist teams during their admission? Keep up the good work promoting frailty recognition!