Implementation of an integrated, multidisciplinary team model of screening, assessment and intervention for the elderly population in a medical assessment unit in Galway University Hospital, Ireland

Abstract

Older adults account for 40-50% of acute hospital admissions (RCPI, 2010). With an ageing population, this figure is set to rise. Frail elderly who attend A&E are at a higher risk of reattending and readmission within 3months. The medical assessment unit was developed in GUH in 2016, with a HSCP team of OT, MSW, physio, dietician and SLT. The aim of this HSCP team was to provide rapid assessment and intervention for individuals over 70 years of age, to avoid unnecessary admissions, reduce the risk of repeat admissions, and begin complex discharge planning from the outset of a patients presentation at hospital. In November 2016, there was a throughput of 100 people in AMU in GUH. Of these 100 people, all adults over the age of 70 were screened using a common screening tool by either OT, MSW or PT. Any who required further intervention were highlighted by the primary screening therapist and followed up on, the same day, by the other members of the HSCP team. Of the 100 patients who came through AMU, 61 patients were screened by either OT, MSW or Physio based on a screening criteria common to each profession. Of the 61 patients screened, 45 patients received therapy from either OT, PT or MSW. The average length of stay was 2.8days. 39 patients were admitted to hospital following assessment in AMU with the longest LOS being 16days. There were increased volumes of patients coming through the AMU service, with a large number of the over 70's getting in contact with therapists at an early stage in their disease/frailty process, thus leading to improved outcomes and patient centred discharge planning.