69ADMISSION TO OUR FRAILTY UNIT REDUCES LENGTH OF STAY AND READMISSION RATE WHEN COMPARED TO USUAL CARE

Abstract

Background: Comprehensive Geriatric Assessment (CGA) improves outcomes for older people admitted to hospital as an emergency. Our Frailty Unit (FU) provides rapid access to CGA for frail older people. We compare outcomes for patients admitted to the FU with patients who have been accepted for the unit but are admitted elsewhere due to lack of an available bed. Innovation: All patients who are identified as suitable for the FU are assessed by a Frailty Practitioner in the Emergency Department or Acute Medical Unit. Patients may be eligible for admission to the FU if they have one or more frailty syndromes, are 75 and over and are unlikely to need prolonged inpatient medical treatment. From Monday to Friday, patients on the FU are seen on daily consultant ward rounds and receive twice daily multi-disciplinary team (MDT) discussion at a board round at 9am and an MDT meeting at 12.30pm. Patients admitted to geriatric wards receive CGA but not daily MDT meetings nor daily consultant review. Patients who are admitted to other wards do not receive CGA. Evaluation: Between 1/7/2015 and 31/11/2015, there were 383 patients admitted to the FU and 65 patients admitted to other wards. Of the 65, 50 were admitted to geriatric wards, 9 to general medical wards, 5 were discharged from the Emergency Department and 1 was admitted to a surgical ward. Conclusion(s): Admission to our FU reduces length of stay and readmission rate compared to usual care. Early assessment, twice-daily communication within the MDT and daily consultant review improve patient outcomes (Table presented).