Abstract
Introduction:
Population is growing old worldwide and UK is no exception. Health service models designed to cater the needs of service users are under immense pressure due to the aging phenomenon. With unprecedented demand, their often low acuity, hence low priority and delayed conveyance to hospital and unavailability of services to address their needs due to delayed arrival; frail older patients often have to wait longer in emergency department (ED) to receive care in ED. Innovation and news models of care are therefore need of the hour to address this challenging situation.
Methods:
Quality improvement initiative to establish acute frailty service.
Development of Older Person assessment unit (OPAU) in Oct 2022 with already established and functional acute frailty team.
Plan for direct referral to OPAU from South East coast ambulance service (SECAmb) colleagues.
Weekly meetings with SECAmb.
Geriatrician of the Day supporting alternative pathways instead of ED.
Development of frailty poster with criteria to referral and uploaded on SECAmb work iPads, displayed in ambulances delivery area and ambulance queuing area inside the hospital.
Single point of access phone number launched April 2023 to access frailty team & other alternative services from outside the hospital.
SECAmb webinar for education and awareness of alternative pathways (UCR, SDEC, frailty, virtual ward), attended by 40 front line SECAMB staff.
Results:
October 2022 – 0 patients.
November 2022 – 2 patients.
December 2022 – 8 patients.
January 2023 – 18 patients.
February 2023 – 32 patients.
March 2023 – 33 patients.
April 2023 – 39 patients.
Conclusion:
With sustained efforts and effective collaboration, number of patients being referred to alternate pathway (frailty team) are increasing with anticipated significant reduction to SECAmb conveyance to ED in the long run, addressing overcrowding issues.