29 * IMPACT OF EARLY COMPREHENSIVE GERIATRIC ASSESSMENT IN PATIENTS ADMITTED TO WIGAN INFIRMARY

Abstract

Background: Previous research has demonstrated the benefit of an early (within 24 hours) Comprehensive Geriatric Assessment (CGA) amongst elderly patients presenting to hospital1. CGA should encompass all aspects of the patient's health in a single process and allow for advanced care planning. This process has been shown elsewhere to reduce length of stay (LOS).Innovation: Previous research has been based within large clinical settings with many resources. This project aimed to assess whether the early CGA process could be effectively delivered within a small DGH environment with limited resources and Geriatricians. The project was carried out by a single Geriatric trainee and Nurse Practitioner whilst continuing with their usual clinical commitments, reflecting the limited recourses of many DGH's. All CGA's were performed within twenty-four hours of admission to RAEI using a pre-piloted CGA document. The results and recommendations from the CGA were communicated to the patient's medical team for on-going care.Evaluation: 20 patients were assessed over an 8 week period. Each CGA led to recommended acute interventions and advanced care planning. Acute interventions recommended included further medical investigations, social care planning, medication review, falls assessment and the need for rehabilitation. Advanced care planning requirements were identified for increased social care, psychogeriatric services, community matron support, respite care, and referral to specialist heart failure, palliative care, diabetes, continence and falls teams.Mean LOS amongst the CGA group was to 5.9 days compared with 12.2 days amongst the general Geriatric admissions to the RAEI.Conclusion: Despite limited time and skilled resources the early CGA can be effectively delivered within the DGH setting and reduces length of stay. It enables early speciality Geriatric involvement in care to allow early and effective advanced care planning.