Frailty and Frailty Virtual Ward Education for Care Home Staff: Reducing Emergency Department Admissions
Abstract
Introduction
The United Kingdom (UK) has an ageing population, with adults aged over 65 years representing the highest users of health care services, contributing to increasing pressure on hospitals and Emergency Departments (EDs), including prolonged waiting times and capacity challenges. In response, there has been development of Virtual Frailty Wards (VFWs). However, there remains a gap in education for care home staff, who are responsible for initiating ambulance callouts, contributing to avoidable ED attendances.
Methods
A quantitative design was utilised, a retrospective review of ED attendances from all local care homes to a single hospital site was conducted using 2023 and 2024 data. Four care homes with the highest attendance rates were identified and selected for intervention.
An educational programme on frailty recognition, management and referral pathways to the VFW was delivered to staff within these care homes. Pre- and post-intervention questionnaires assessed staff knowledge of frailty and VFW services.
ED attendance data from the four care homes were collected for a six-week period post intervention and compared with equivalent periods in 2023 and 2024. Questionnaire responses were analysed, using descriptive statistics.
Results
Training was delivered to 51 staff members from a total workforce of 73 across four care homes. Following the intervention, there was a 48% reduction in ED attendances compared with the equivalent in 2024 and 2023 (2023: n = 54, 2024: n = 52, 2025: n = 25). Awareness of the VFW increased by 45% following the education session.
Conclusion
The educational intervention indicated a reduction in ED attendances from the care homes compared to retrospective years. Staff knowledge and awareness utilising the VFW improved following training. Providing education on frailty-related conditions enabled care home staff to increase support for residents, facilitating access to medical care without hospital transfer. Reducing hospital-associated harms and promoting person-centred care.