76 This is (Probably) Not the Frailty Solution You are Looking For: Utilisation of A Novel Stand-Alone Community-Based Ambulatory Care Unit

Abstract

Introduction/Aim: Our organisation wished to expand its “Care Closer To Home” capability, especially for older and/or frail patients.Our novel AmbulatoryCareUnit (ACU) in a community hospital, staffed by GPs & nurses, opened a year ago.The ACU has some Point ofCare (POCT) diagnostics, access to plain-film radiography andOT/physio.During the planning of the unit,” acute frailty” was anticipated to be core business. We wished to determine whether this turned out to be the case. Method: Interrogation of the ACU patient log (spreadsheet collated from Data Collection Forms) Dec 2018-Nov 2019. Results: • Of the 587 patients seen in the ACU, 277 (47%) were 370 years old (mean 64.5,median 69). • 58/587 patients saw a physiotherapist during their ACU visit(s), 51/587 an OT, and 21/587 were referred to community services (half by the ACU therapists). • Clinical Frailty Scale (Rockwood) was recorded in only 357/587, but of these, 105 (29%) had a CFS of 5–8. • 35/105 (33.3%) had seen our physio, 26/105 (25%) OT, nine (8.6%) were referred to community services, and nine were admitted as too unwell to manage on an ambulatory basis. Conclusion/Discussion: Recording of CFS by ACU staff was poor, limiting the validity of our results. Nevertheless, it is obvious that most patients seen in our ACU are not frail, and do not require therapies input.Those that are frail, however, have an acceptable conversionto- admission rate of 8.6%, comfortably below the national target (20%). Barriers to greater utilisation of our service for frail patients may include lack of urgent but non-emergency transport options for the less mobile, lack of access to certain commonlyused tests (e.g. CT, troponin) and referrer anticipation of difficulty discharging the frail patient in crisis without a new or boosted care package and/or access to respite beds. These aspects of service planning need to be addressed if the potential utility of community-based units like ours for frail patients is to be maximised. 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.)