An Acute Frailty Unit with focused MDT input decreases inpatient length of stay for older persons presenting with frailty syndrome(s)

An Acute Frailty Unit with focused MDT input decreases inpatient length of stay for older persons presenting with frailty syndrome(s). A Warner

Introduction

Older persons experiencing frailty are at risk of prolonged hospital stay causing adverse outcomes including mental and physical deconditioning, infections and falls (1). Tackling length of stay by ensuring patients return to their usual place of residence promptly, improves patient’s health and hospital flow (2)

An Acute frailty unit (AFU) consisting of 3 male, and 3 female beds was established on the older persons ward (OPW) providing treatment by dedicated allied health and medical professionals. 

Method

Patients presenting to ED were assessed by the Early Intervention or Acute Frailty teams and were selected for admission to AFU unit if meeting specific criteria. Each patient received a comprehensive geriatric assessment, holistic physiotherapy assessment and rapid approach to discharge planning with the integrated discharge team. Data collected for patients attending AFU for March 2021, MDT cover provided Monday to Friday, 8am – 4pm. The remaining 32 beds on the OPW were covered by the existing older person’s team.

Results

AFU had 38 patients, with an average LOS of 3.6 days. 45% of patients were discharged within 24 hours of admission to AFU, increasing to 56% at 48 hours and 77% within 72 hours.

66% patients discharged to their normal residence, 16% to a community rehabilitation unit prior to normal residence, 18% to the OPW due to delay in sourcing a care package and 1% required onwards medical attention.

OPW had 47 patients, with an average LOS of 9 days. 15% of patients were discharged within 72 hours. 75% of patients returned to their normal residences.

Conclusion

The implementation of AFU was highly effective and significantly improved the length of stay of frail older persons, patient health, patient flow and reduced the cost of in-patient care. The obstacle preventing more discharges to normal residence is the lack of community care availability at point of requesting.

References