Abstract
Background
Evidence shows that CGA based in Frailty units is better for patient care (Fox 2012, Ellis 2011). University Hospital Wishaw (UHW) is the only acute site in NHS Lanarkshire that does not have a frailty assessment unit as part of the admission/receiving pathway. Patients are currently admitted to the Medical Assessment Unit (MAU) and seen by either Geriatrician or Medical consultant depending on the time of admission. UHW is working towards a frailty unit but has been limited by space and resource. Instead we have been on a journey of step-wise improvements to establish one.
Methods
Over the course of 5 days, we developed a Rapid Access Frailty Team (RAFT) in a cohort of 10 beds within the existing MAU. Patients were over 65 and had a CFS ≥5. Patients were reviewed by a Geriatrician in morning and afternoon, and had MDT input from Physiotherapy, Occupational Therapy and a Nurse specialist.
Results
Over the 5 days 28 patients were admitted to RAFT beds. 9/28 (32%) were discharged from RAFT. Length of stay was 32 hours. Patients either went home or moved to a downstream ward if needed. Medical and AHP staff feedback was positive, but nursing staff in MAU voiced it was onerous having all frail adults in one area.
Conclusions
Development of frailty area within a medical assessment unit is possible and appears to lead to improved outcomes and discharge rates compared to non-cohorted areas. We are now looking for an area where we can apply our RAFT principles and have more staff support.