94 The Comprehensive Frailty Assessment At Forth Valley Royal Hospital (FVRH) Digitalised: For COVID-19 and Beyond!

Abstract

Introduction: Comprehensive Geriatric Assessment (CGA) improves outcomes for frail patients; at FVRH this is delivered by the Frailty Intervention Team (FIT) comprising of senior nurses, allied health professionals (AHPs) and doctors. Faced with COVID-19, we took the opportunity to digitalise CGA documentation to preserve these benefits for patients whilst facing greater acuity, staffing and time pressures. An electronic solution was adopted to reduce paper-usage in COVID-receiving areas. Prior to COVID-19, CGA was recorded within case-notes, presenting challenges when patients were readmitted out-ofhours as these were stored off-site and not accessible out-of-hours. Method: Trakcare is the patient-management system in many Scottish hospitals. The Electronic Patient Record (EPR) was used to record pro-forma against admissions which were accessible and updatable for any patient 24–7-365. Patients meeting the Healthcare Improvement Scotland (HIS) Frailty criteria were considered “frailty-positive”, with an e-alert added- reappearing on any re-admission. Providing no HIS-exclusion criteria, an electronic-CGA (e-CGA) was recorded or updated. The pro-forma designed contained information not immediately available to clerking practitioners. This evolved following discussion amongst the FIT to include information such as escalation-status, medicationarrangements and baseline cognition. Results: Over 13 weeks, 116 EPRs were reviewed. During weeks 1–3 (n=8, 12, 7 respectively), e-CGA completion averaged 31%. Following FIT collaboration, this rose to 82% (n=9) by week 12. Qualitative feedback from the MDT indicated that FIT, downstream wards and night-staff felt that having access to previous escalation-plans made immediate-management easier to determine, and discussions with familiesmore productive for patients. Conclusions: Development of the FVRH e-CGA is ongoing, with an electronic frailtyscreening tool being implemented to improve frailty-identification on admission to ensure correct streaming of patients to the FIT. We have demonstrated a cost-neutral method for improving access to CGA for patients using existing IT systems whilst protecting staff time, preserving patient care during the COVID-19 pandemic. ABSTRACT FROM AUTHOR (Copyright of Age & Ageing is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.)