Background This quality improvement (QI) work was done at the South Edinburgh Parkinson’s clinic. Introduction Idiopathic Parkinson’s disease (IPD) is a secondary risk factor for osteoporosis (Torsney KM et al. Journal Neurology Neurosurgery Psychiatry 2014; 85: 1159–1166). The 2022 UK Parkinson’s audit highlighted bone health as an area of QI for IPD ( www.Parkinsons.org.uk). Methods A Plan-Do-Study-Act (PDSA) structure was adopted and project charter created. Baseline data was collected from 20 patients attending the IPD clinic between June- September 2023, reviewing details of assessments
Introduction: Delirium, an acute neuropsychiatric syndrome, affects one in four hospitalised older adults. Effective management requires timely detection using validated tools and a structured approach to causes and sequelae. There is limited evidence on contextual factors surrounding assessment tool implementation and delirium management. The primary aim of this study was to describe the use of validated delirium assessment tools across Scotland, with a secondary aim of describing protocols for delirium management and barriers to implementation. Methods: This was a secondary analysis of
Background Older people account for >40% of acute hospital admissions. Delivering alternatives to hospital admission and community-integrated care closer to home are increasing priorities. We aimed to develop an Emergency Department (ED) Frailty MDT to provide rapid assessment, early Comprehensive Geriatric Assessment (CGA), and reduce inpatient admission rates for frail older people. Methods From November 2023 to April 2024, a newly formed Royal Infirmary of Edinburgh ED Frailty team delivered CGA for older adults aged ≥75 (≥65 if care home resident) with Clinical Frailty Scores ≥5 in the ED
Background and aims Delirium carries an eightfold risk of future dementia. Small vessel disease (SVD), best seen on MRI, increases delirium risk, yet delirium is understudied in MRI research. We aimed to determine MRI feasibility, tolerability, image usability, and prevalence of acute and chronic SVD lesions in acute delirium. Methods This case-control feasibility study performed MRI (3D T1/T2-weighted, FLAIR, Susceptibility-weighted, and Diffusion-weighted imaging (DWI) on 20 medical inpatients >65 years: 10 with delirium ≥3 weeks and 10 without delirium, matched for vascular risk, Clinical
Background: Heart Failure (HF) is a major cause of poor health, hospitalisation, and death, particularly amongst older people. Routinely prescribed HF medication can improve these outcomes, but many patients do not take their medications. Aims: To develop a tailored multi-component intervention to enhance medication adherence in older HF patients in preparation for a future pilot RCT. Objectives: To determine what intervention components and strategies are necessary and acceptable to create a support package to help and encourage HF patients to take their medication regularly. To develop an
Introduction High-dose corticosteroids have significant benefits for infective exacerbations of COPD, reducing risk of relapse, length of hospital stay and earlier symptom improvement. However, recurrent use has been shown to increase risk of comorbidities including osteoporosis, type two diabetes mellitus (T2DM), cardiovascular disease, hypertension, and elevated body mass index (BMI). This audit assessed how many patients at Anchor Mill Medical Practice in Paisley, who had been prescribed two or more courses of prednisolone in the six months prior to the start of data collection, had been
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
INTRODUCTION: Our QIP was conducted in the Geriatric wards at Royal Gwent Hospital by doctors working in Geriatrics. Delirium, falls, confusion and urinary retention are common reasons for hospital admission in the elderly. Anticholinergic burden (ACB) is the cumulative effect of taking multiple medicines with anticholinergic properties contributing to frequent admissions. The aim of our QIP was to increase doctor’s awareness of ACB and encourage the review and deprescribing of regular medications in elderly patients to decrease ACB. METHODS: ACB was measured on admission and discharge using
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
Introduction At Epsom and St Helier, a dedicated Frailty service exists during daytime hours, and not weekends, nights or Bank Holidays. During these hours, patients are reviewed primarily by a cohort of “frailty-naïve” medical junior doctors. We aimed to compare the management plans, patient outcomes, rates of discharge, documentation and care delivered by medical junior doctors to that of an established frailty service. Methodology Data on presenting complaint, demographics, degree of frailty, postcode was collected on all patients over the age of 65, presenting to A&E at Epsom and St Helier
INTRODUCTION: Medical students may find practical aspects of the transition to FY1 doctor challenging. In recent years medical curriculums have been updated to address this issue by increasing the emphasis on assistantships and practical learning. We explored how prepared final year medical students felt for managing common scenarios in geriatrics, such as a patient with delirium or inpatient falls. This allowed us to develop a tailored teaching programme to be delivered by junior doctors with relevant practical experience. METHODS: 1) We surveyed assistantship students in geriatrics to
Introduction The Frailty Network, initiated in November 2023, aims to enhance care for frail patients through multidisciplinary collaboration across acute and community settings. By fostering partnerships with Health and Social Care teams, GPs, district nurses, and third sector organisations, the Network strives to provide realistic and patient-centric improvements in Lanarkshire. The initiative focuses on proactive, personalised, and coordinated support to help frail older adults maintain independence and well-being. Methods The Frailty Network is supporting multiple teams to implement new