85Managing Frail Patients in the Acute Setting: Rapid Assessment Frailty Team (RAFT)

Abstract

Background: Older people are the most common cohort that present to the ED. RAFT attempt to identify frail patients at assessment in ED. Early identification of frailty at the point of admission in ED has implications for management and discharge planning. Efforts to avoid admission should be employed when possible as functional decline is directly proportional to bed rest in frail patients. Method(s): The FRAIL questionnaire was applied to all patients assessed in the ED at triage. Any patient scoring > 1 was referred to physio or OT. Those Frail patients admitted, scoring 4-6 on the Clinical Frailty scale were referred to the Frailty ANP, and ward OT and Physio at the point of admission. Analysis of LOS or discharge destination were used to access effectiveness of this intervention. Result(s): In the 17 weekday period, (February 2018), 113 patients identified as FRAIL were seen by RAFT. Only 52 of/113 were over 75 yrs of age, 25/113 frail patients were under 65 yrs of age. 27/113 (30.6%) patients accessed by RAFT were discharged and the remaining admitted. The average LOS of those > 65 yrs admitted seen by RAFT was 6.2 days. When compared to 2017 the LOS was 9.4 days for those > 65 year olds admitted in same period. Conclusion(s): From above we can see that there is a significant benefit in having an acute frailty team in ED both for the patient and financially for the hospital. Early identification of patients who can be safely discharged following assessment and intervention can prevent unnecessary admission, sarcopenia and functional decline. Further studies into the benefit of such intervention in younger patients identified as frail are warranted according to above statistics as most studies in this field look mainly at > 75 age group.