Abstract
Introduction
Older people living with frailty are core users of health and social care. Services attuned to the needs of people with frailty afford better outcomes, help avoid harm and improve the experience for people and those who care for them. Such services can also help with flow and capacity. The Glasgow Royal Infirmary (GRI) Team aimed to advance services in order to enhance the quality and provision of care for older people with frailty.
Methods
As part of the Health Improvement Scotland Focus on Frailty Programme, the GRI Team developed processes for early identification of people living with frailty, using an electronic Frailty Assessment Tool. Processes were designed to streamline patients with frailty to specialist areas of care in order to initiate early Comprehensive Geriatric Assessment (CGA). A Frailty Assessment Proforma was created to swiftly identify the priorities, concerns and goals of patients and carers and to gather key collateral information promptly. Daily CGA Huddles were commenced which include participants from various different health and social care services. Work is now being done towards the development of a dedicated Frailty Assessment Area and a trial of Rapid Access appointments at the Assessment and Rehabilitation Centres is being undertaken.
Results
There has been an improvement in frailty identification. 79% patients over the age of 75 years, who are admitted through the Acute Medical Receiving Unit, are being screened for frailty. There has been improvement noted in terms of access and time to a specialty bed. Further, there has been a reduction in length of stay for people with frailty, coupled with a reduction in readmissions at 7 and 30 days.
Conclusion
Frailty attuned acute services help patients receive timely, specialist care. They help reduce time spent in hospital and readmissions which, in turn, can contribute to improved flow and capacity.